Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
Department of Critical Care Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan City, 442000, People's Republic of China.
BMC Cardiovasc Disord. 2023 Mar 30;23(1):172. doi: 10.1186/s12872-023-03191-1.
An abdominal aortic aneurysm is a life-threatening enlargement in the major vessel at the abdomen level. This study investigated the associations between different levels of red blood cell distribution width and all-cause mortality among patients with abdominal aortic aneurysm rupture. It developed predictive models for all-cause mortality risk.
This was a retrospective cohort study using 2001 to 2012 MIMIC-III dataset. The study sample included 392 U.S. adults with abdominal aortic aneurysms who were admitted to ICU after the aneurysm rupture. Then we used two single-factor and four multivariable logistic regression models to examine the associations between different levels of red blood cell distribution and all-cause mortality (30 days and 90 days), controlling for demographics, comorbidities, vital signs, and other laboratory measurements. The receiver operator characteristic curves were calculated, and the areas under the curves were recorded.
There were 140 (35.7%) patients with an abdominal aortic aneurysm in the red blood cell distribution width range between 11.7 and 13.8%, 117 (29.8%) patients in the range between 13.9 and 14.9%, and 135 (34.5%) patients in the range between 15.0 and 21.6%. Patients with higher red blood cell distribution width level (> 13.8%) tended to have a higher mortality rate (both 30 days and 90 days), congestive heart failure, renal failure, coagulation disorders, lower hemoglobin, hematocrit, MCV, red blood cell count, higher levels of chloride, creatinine, sodium, and BUN (All P < 0.05). Results of multivariate logistic regression models indicated that patients with higher red blood cell distribution width levels (> 13.8%) had the highest statistically significant odd ratios of 30 days and 90 days of all-cause mortality than lower red blood cell distribution width levels. The area under the RDW curve was lower (P = 0.0009) than that of SAPSII scores.
Our study found that patients with abdominal aortic aneurysm rupture with a higher blood cell distribution had the highest risk of all-cause mortality. Using the blood cell distribution width level in patients with abdominal aortic aneurysm rupture to predict mortality should be considered in future clinical practice.
腹主动脉瘤是一种危及生命的腹部主要血管扩张。本研究调查了不同红细胞分布宽度水平与腹主动脉瘤破裂患者全因死亡率之间的关系。它为全因死亡率风险开发了预测模型。
这是一项使用 2001 年至 2012 年 MIMIC-III 数据集的回顾性队列研究。研究样本包括 392 名美国成年人，他们在腹主动脉瘤破裂后被收入 ICU。然后，我们使用两种单因素和四种多变量逻辑回归模型来检查不同红细胞分布水平与全因死亡率（30 天和 90 天）之间的关系，控制人口统计学、合并症、生命体征和其他实验室测量值。计算了接收者操作特征曲线，并记录了曲线下面积。
在红细胞分布宽度范围在 11.7 到 13.8%之间的 140 名（35.7%）患者中，有 13.9 到 14.9%之间的 117 名（29.8%）患者，在红细胞分布宽度范围在 15.0 到 21.6%之间的 135 名（34.5%）患者。红细胞分布宽度水平较高（>13.8%）的患者死亡率较高（30 天和 90 天），充血性心力衰竭、肾衰竭、凝血障碍、血红蛋白、红细胞压积、MCV、红细胞计数较低，氯、肌酐、钠和 BUN 水平较高（均 P<0.05）。多变量逻辑回归模型的结果表明，红细胞分布宽度水平较高（>13.8%）的患者全因死亡率的统计显著优势比最高，高于较低的红细胞分布宽度水平。RDW 曲线下面积较低（P=0.0009），低于 SAPSII 评分。
我们的研究发现，腹主动脉瘤破裂患者的血细胞分布较高，全因死亡率风险最高。在未来的临床实践中，应考虑使用腹主动脉瘤破裂患者的血细胞分布宽度水平来预测死亡率。
