The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
ESC Heart Fail. 2022 Oct;9(5):3210-3220. doi: 10.1002/ehf2.14023. Epub 2022 Jun 29.
There is limited evidence for the correlation between short-term mortality and red cell distribution width (RDW) in critical patients with heart failure. Herein, a retrospective cohort study was conducted to investigate whether RDW was independently associated with short-term mortality in critically ill patients with heart failure.
As a retrospective cohort study, it involved a total of 9465 patients with heart failure from the MIMIC-IV database. The target-dependent and independent variables were in-hospital mortality, 90 day mortality and RDW measured at baseline, respectively. The relationship between all-cause death and baseline RDW in hospital and after 90 days of admission to ICU was evaluated by using the Kaplan-Meier plot and Cox proportional hazard analysis. The average age of participants was 74.4 (64.2, 83.5) years old, among whom about 54.6% were male. Results of the adjusted Cox proportional hazard model revealed that RDW had a positive association with both in-hospital and 90 day mortality risk after the adjustment of confounders (HR = 1.09, 95% CI: 1.04-1.15, P < 0.001; HR = 1.11, 95% CI: 1.08-1.14, P < 0.001, respectively). A non-linear relationship was found between RDW and 90 day mortality, which had a threshold of 14.96%. The effect sizes and confidence intervals below and above the threshold were 1.36 (1.14 to 1.62) and 1.09 (1.04 to 1.15), respectively. It was also found by subgroup analysis that there were stronger correlations in male and patients with normal renal function.
Our data suggest that the short-term mortality of critically ill patients with HF is independently predicted by RDW. At the same time, large prospective research and longer follow-up time are required to further validate the findings of this study.
心力衰竭危重症患者短期死亡率与红细胞分布宽度（RDW）的相关性证据有限。在此，进行了一项回顾性队列研究，旨在探讨 RDW 是否与心力衰竭危重症患者的短期死亡率独立相关。
作为一项回顾性队列研究，共纳入来自 MIMIC-IV 数据库的 9465 例心力衰竭患者。因变量为住院死亡率、90 天死亡率和基线时测量的 RDW，目标相关和独立变量分别为。采用 Kaplan-Meier 图和 Cox 比例风险分析评估全因死亡与住院时和入住 ICU 后 90 天的基线 RDW 之间的关系。参与者的平均年龄为 74.4（64.2，83.5）岁，其中约 54.6%为男性。调整混杂因素后，Cox 比例风险模型的结果显示，RDW 与住院和 90 天死亡率风险均呈正相关（HR=1.09，95%CI：1.04-1.15，P<0.001；HR=1.11，95%CI：1.08-1.14，P<0.001）。RDW 与 90 天死亡率之间存在非线性关系，其阈值为 14.96%。阈值以下和以上的效应大小和置信区间分别为 1.36（1.14 至 1.62）和 1.09（1.04 至 1.15）。亚组分析还发现，在男性和肾功能正常的患者中，相关性更强。
我们的数据表明，RDW 可独立预测心力衰竭危重症患者的短期死亡率。同时，需要进行更大规模的前瞻性研究和更长时间的随访，以进一步验证本研究的结果。
