Hu Bin, Cao Jinxia, Hu Yangyang, Qin Zuoan, Wang Jun
Department of Hematology, First People's Hospital of Changde City, Changde, Hunan, People's Republic of China.
Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Int J Gen Med. 2021 Nov 16;14:8301-8309. doi: 10.2147/IJGM.S329296. eCollection 2021.
Studies regarding death risk factors of disseminated intravascular coagulation (DIC) patients were limited. We conducted this study to investigate whether red blood cell distribution width (RDW) was independently related to all-cause mortality of DIC patients.
We used data from the Medical Information Mart for Intensive Care III version 1.4 (MIMIC-III v1.4). A total of 2098 patients with DIC were included. The main outcome was in-hospital all-cause mortality.
After adjusting for potential covariates, the in-hospital all-cause mortality was positively correlated with RDW. The hazard ratio (HR), 95% confidence intervals (CI), and P-value were 1.08, (1.05, 1.12), and P<0.0001, respectively. The Kaplan-Meier curve found DIC patients with elevated RDW had a lower survival rate than patients with normal RDW (P<0.0001). A nonlinear relationship between RDW and mortality was found with the inflection point 19.2%. When RDW <19.2%, RDW was positively correlated with in-hospital all-cause mortality of DIC patients (HR (95% CI): 1.17 (1.11, 1.24), P<0.0001). An elevation in RDW greater than 19.2% did not result in an additional increased risk of mortality (HR=0.97, 95% CI: 0.91-1.04, P=0.4617).
RDW is an independent predictor of all-cause mortality in DIC patients. Furthermore, there is a nonlinear association between RDW and all-cause mortality of DIC patients.
关于弥散性血管内凝血(DIC)患者死亡危险因素的研究有限。我们开展本研究以调查红细胞分布宽度(RDW)是否与DIC患者的全因死亡率独立相关。
我们使用重症监护医学信息集市三期版本1.4(MIMIC-III v1.4)的数据。共纳入2098例DIC患者。主要结局为院内全因死亡率。
在对潜在协变量进行校正后,院内全因死亡率与RDW呈正相关。风险比(HR)、95%置信区间(CI)和P值分别为1.08、(1.05,1.12)和P<0.0001。Kaplan-Meier曲线显示,RDW升高的DIC患者生存率低于RDW正常的患者(P<0.0001)。发现RDW与死亡率之间存在非线性关系,拐点为19.2%。当RDW<19.2%时,RDW与DIC患者的院内全因死亡率呈正相关(HR(95%CI):1.17(1.11,1.24),P<0.0001)。RDW升高超过19.2%并未导致额外的死亡风险增加(HR=0.97,95%CI:0.91-1.04,P=0.4617)。
RDW是DIC患者全因死亡率的独立预测指标。此外,RDW与DIC患者的全因死亡率之间存在非线性关联。