Xu Weigan, Huo Jianyang, Chen Guojun, Yang Kangyi, Huang Zuhua, Peng Lina, Xu Jingtao, Jiang Jun
Department of Emergency, First People's Hospital of Foshan, Foshan, China.
The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China.
Front Nutr. 2022 Sep 23;9:1019502. doi: 10.3389/fnut.2022.1019502. eCollection 2022.
Red blood cell distribution width (RDW) to albumin ratio (RAR) is associated with poor prognosis in diabetic comorbidities and cancer. However, the association between RAR and prognosis in patients with sepsis remains unclear, which was investigated in this study.
We conducted a retrospective cohort study based on the Medical Information Mart for Intensive Care (MIMIC) IV version 2.0 database. The primary outcome of this study was 28-day mortality. Secondary outcomes included 90-day mortality, in-hospital mortality, length of hospital stay, and length of intensive care unit (ICU) stay. Multivariate regression analysis and subgroup analysis were performed to investigate the association between RAR and prognosis in patients with sepsis.
A total of 14,639 participants were included in this study. The mean age of the participants was 65.2 ± 16.3 years and the mean RAR was 5.5 ± 1.9 % /g/dl. For 28-day mortality, after adjusting for covariates, HRs [95% confidence intervals (CIs)] for tertiles 2 (4.4-5.8) and 3 (RAR > 5.8) were 1.33 (1.20, 1.46) and 1.98 (1.79, 2.19), respectively. Similar results were observed for 90-day mortality and in-hospital mortality. According to Kaplan-Meier curve analysis, the higher RAR group had higher 28-day mortality and 90-day mortality.
Our study shows that RAR is significantly associated with poor clinical prognosis in sepsis. The higher the RAR, the higher the 28-day, 90-day, and in-hospital mortality.
红细胞分布宽度（RDW）与白蛋白比值（RAR）与糖尿病合并症和癌症的不良预后相关。然而，RAR与脓毒症患者预后之间的关联仍不明确，本研究对此进行了调查。
我们基于重症监护医学信息集市（MIMIC）IV版本2.0数据库进行了一项回顾性队列研究。本研究的主要结局是28天死亡率。次要结局包括90天死亡率、住院死亡率、住院时间和重症监护病房（ICU）住院时间。进行多变量回归分析和亚组分析以研究RAR与脓毒症患者预后之间的关联。
本研究共纳入14639名参与者。参与者的平均年龄为65.2±16.3岁，平均RAR为5.5±1.9%/g/dl。对于28天死亡率，在调整协变量后，第二三分位数（4.4 - 5.8）和第三三分位数（RAR>5.8）的HRs[95%置信区间（CIs）]分别为1.33（1.20，1.46）和1.98（1.79，2.19）。90天死亡率和住院死亡率也观察到类似结果。根据Kaplan-Meier曲线分析，RAR较高组的28天死亡率和90天死亡率更高。
我们的研究表明，RAR与脓毒症患者不良临床预后显著相关。RAR越高，28天、90天和住院死亡率越高。
