Relationship Between the Hemoglobin-to-Red Cell Distribution Width Ratio and All-Cause Mortality in Ischemic Stroke Patients with Atrial Fibrillation: An Analysis from the MIMIC-IV Database

Qin, Z. H.; Liao, N; Lü, Xiaomei; Duan, Xiangjie; Zhou, Qian; Ge, Liang

doi:10.2147/ndt.s350588

Cited by 9 publications

(13 citation statements)

References 36 publications

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“…It is widely employed in the early differential diagnosis of anemia [ 6 ]. Recent research has revealed a strong correlation between a high RDW and the prognosis of a variety of serious diseases, including cancer [ 7 ], cardiovascular diseases [ 8 ], ischemic stroke [ 9 ], and acute respiratory distress syndrome (ARDS) [ 10 ]. RA is the ratio of RDW to albumin, and a study showed that the predictive value of RA in stroke patients is even greater than that of RDW [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Novel Nomogram Incorporating Red Blood Cell Distribution Width-Albumin Ratio for the Prediction of 30-day Mortality in Acute Pancreatitis Patients

Pan

Lei

et al. 2022

Emergency Medicine International

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Purpose. The available nomograms used to predict acute pancreatitis (AP) are not comprehensive. We sought to investigate the effect of red blood cell distribution width (RDW)-albumin ratio (RA) on prognosis of patients with AP and develop a new nomogram to identify AP patients at high risk for mortality. Methods. We used data from the Medical Information Mart for Intensive Care IV version 2.0 (MIMIC-IV v2.0). A total of 487 patients with acute pancreatitis were included. Patients enrolled in the study were randomly assigned to the training set and validation set at a 7 : 3 ratio. According to the 30-day mortality rate, the data were divided into a survival group and a death group. Multivariate logistic regression was used to establish a prognostic nomogram for predicting the 30-day mortality in AP patients. The area under the receiver operating characteristic curve (AUC), calibration curve, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and a decision curve analysis (DCA) are used to verify the overall performance of the model. Results. Among 487 patients, 54 patients died (11.1%). 338 patients were assigned to the training cohort and 149 were assigned to the validation cohort. The multivariate analysis results showed that RA, age, heart rate, temperature, AST/ALT, BUN, hemoglobin, potassium, and bilirubin were independent risk factors. The prediction performance of the newly established nomogram was better than those of other common scoring systems (including SOFA, OASIS, and APSIII). The nomogram suggests that RA (OR = 1.706, 95% CI: 1.367–2.185) is the most significant laboratory test indicator influencing prognosis. Conclusion. The new nomogram incorporating RA performed well in predicting AP short-term mortality. A prospective study with a larger sample is needed to validate our findings.

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Section: Introductionmentioning

confidence: 99%

Development of a Novel Nomogram Incorporating Red Blood Cell Distribution Width-Albumin Ratio for the Prediction of 30-day Mortality in Acute Pancreatitis Patients

Pan

Lei

et al. 2022

Emergency Medicine International

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“…A series of previous studies have demonstrated that a low level of HRR was associated with poor outcomes among multiple malignant diseases (25,33,(38)(39)(40)(41). In recent years, there was mounting evidence that a lower level of HRR was strongly associated with significantly worse outcomes in many critically ill patients, such as coronary heart disease (28), sepsis (29), ischemic stroke (30), and so on. One study with 6,046 participants found that a lower HRR (HRR<10.25) in patients with percutaneous coronary atherosclerotic heart disease was associated with a 1.47-fold increased risk of long-term allcause mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations have shown that HRR was associated with inflammation (25)(26)(27). In recent years, more and more evidence has shown that low level of HRR was closely related to significantly deteriorating prognosis in many critically ill patients, such as coronary heart disease, sepsis, and ischemic stroke (28)(29)(30). However, the relationship between HRR and mortality in patients with non-traumatic SAH is lacking.…”

Section: Introductionmentioning

confidence: 99%

Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage

Liu

Wang

2023

Front. Neurol.

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BackgroundIn patients with ischemic stroke, low hemoglobin-to-red blood cell distribution width ratio (HRR) was associated with an increased risk of mortality. However, it was unknown in the non-traumatic subarachnoid hemorrhage (SAH) population. The purpose of this study was to examine the association between baseline HRR and in-hospital mortality in patients with non-traumatic SAH.MethodsNon-traumatic SAH patients were screened out of the Medical Information Mart for Intensive IV (MIMIC-IV) database between 2008 and 2019. The Cox proportional hazard regression models were utilized to analyze the association between baseline HRR and in-hospital mortality. Restricted cubic splines (RCS) analysis was utilized to determine the relationship curve between hospital mortality and the HRR level and examine the threshold saturation effect. We further applied Kaplan–Meier survival curve analysis to examine the consistency of these correlations. The interaction test was used to identify subgroups with differences.ResultsA total of 842 patients were included in this retrospective cohort study. Compared with individuals with lower HRR Q1 ( ≤ 7.85), the adjusted HR values in Q2 (7.86–9.15), Q3 (9.16–10.16), and Q4 (≥10.17) were 0.574 (95% CI: 0.368–0.896, p = 0.015), 0.555 (95% CI: 0.346–0.890, p = 0.016), and 0.625 (95% CI: 0.394–0.991, p = 0.045), respectively. The association between the HRR level and in-hospital mortality exhibited a non-linear relationship (p < 0.05). The threshold inflection point value of 9.50 was calculated using RCS analysis. When the HHR level was lower than 9.50, the risk of in-hospital mortality rate decreased with an adjusted HR of 0.79 (95% CI: 0.70–0.90, p = 0.0003). When the HRR level was higher than 9.50, the risk of in-hospital mortality almost hardly increased with the increase in the HRR level (adjusted HR = 1.18, 95% CI: 0.91–1.53, p = 0.2158). K-M analysis showed that patients with low HRR levels had significantly higher in-hospital mortality (p < 0.001).ConclusionThere was a non-linear connection between the baseline HRR level and in-hospital mortality. A low level of HRR could increase the risk of death in participants with non-traumatic SAH.

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“…There is increasing evidence that HRR is a new prognostic indicator in critically ill patients with malignant diseases. For example, Qin et al explored the nonlinear relationship between all-cause mortality and HRR value in patients with ischemic stroke [ 27 ], and Rahamim et al found that HRR was an important prognostic tool for predicting mortality in heart failure and the hospitalization of patients with cardiovascular disease [ 9 ]. Chi et al found that low HRR were associated with a dual risk of disease progression or cancer recurrence in patients and used them to predict poor prognosis in patients with cancer [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The Hemoglobin-to-Red Cell Distribution Width Ratio to Predict All-Cause Mortality in Patients with Sepsis-Associated Encephalopathy in the MIMIC-IV Database

Huang

Yuan

Ling

et al. 2022

International Journal of Clinical Practice

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Objective. The hemoglobin-to-red cell distribution width ratio (HRR) is associated with the prognosis of sepsis-associated encephalopathy (SAE). This study aimed to determine the relationship between HRR and SAE and to clarify the possible mechanism of HRR as a prognostic factor for SAE. Methods. A multivariate Cox proportional-hazards regression model was used to assess the correlation between HRR and all-cause mortality. Piecewise linear regression and smooth-curve Cox proportional-hazards regression models were used to observe whether there was a nonlinear relationship between HRR and all-cause mortality in SAE. Results. This study included 8853 patients with SAE. A nonlinear relationship between HRR and SAE was observed through a two-segment regression model. The left inflection point for the HRR threshold was calculated to be 15.54, which was negatively correlated with all-cause mortality (HR = 0.83, 95% CI = 0.76–0.91, p < 0.001 ). Subgroup analyses revealed significant interactions between white blood cell count, glucose, and patients who received dialysis and HRR. The inverse correlation between HRR and SAE was more pronounced in patients who did not receive vasopressin (HR = 0.91, 95% CI = 0.87–0.96, p < 0.001 ) than in those who did receive vasopressin (HR = 0.94, 95% CI = 0.88–1.02, p = 0.152 ) and was significantly more pronounced in patients without myocardial infarction (HR = 0.91, 95% CI = 0.88–0.96, p < 0.001 ) than in those with myocardial infarction (HR = 0.94, 95% CI = 0.87–1.02, p < 0.114 ). Conclusion. This large retrospective study found a nonlinear relationship between all-cause mortality and HRR in patients with SAE in intensive care units, with low HRR being inversely associated with increased all-cause mortality in patients with SAE.

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Relationship Between the Hemoglobin-to-Red Cell Distribution Width Ratio and All-Cause Mortality in Ischemic Stroke Patients with Atrial Fibrillation: An Analysis from the MIMIC-IV Database

Cited by 9 publications

References 36 publications

Development of a Novel Nomogram Incorporating Red Blood Cell Distribution Width-Albumin Ratio for the Prediction of 30-day Mortality in Acute Pancreatitis Patients

Development of a Novel Nomogram Incorporating Red Blood Cell Distribution Width-Albumin Ratio for the Prediction of 30-day Mortality in Acute Pancreatitis Patients

Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage

The Hemoglobin-to-Red Cell Distribution Width Ratio to Predict All-Cause Mortality in Patients with Sepsis-Associated Encephalopathy in the MIMIC-IV Database

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