Peng Shixuan, Li Wenxuan, Ke Weiqi
Department of Oncology, Graduate Collaborative Training Base of The First People's Hospital of Xiangtan City, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Department of Anesthesiology, The First People's Hospital of Yueyang, Yueyang, Hunan, China.
Front Med (Lausanne). 2023 Mar 30;10:1152058. doi: 10.3389/fmed.2023.1152058. eCollection 2023.
Although red cell distribution width (RDW) is widely observed in clinical practice, only a few studies have looked at all-cause mortality in unselected critically ill patients, and there are even fewer studies on long-term mortality. The goal of our study was to explore the prediction and inference of mortality in unselected critically ill patients by assessing RDW levels.
We obtained demographic information, laboratory results, prevalence data, and vital signs from the unselected critically ill patients using the publicly available MIMIC-III database. We then used this information to analyze the association between baseline RDW levels and unselected critically ill patients using Cox proportional risk analysis, smoothed curve fitting, subgroup analysis, and Kaplan-Meier survival curves for short, intermediate, and long-term all-cause mortality in unselected critically ill patients.
A total of 26,818 patients were included in our study for the final data analysis after screening in accordance with acceptable conditions. Our study investigated the relationship between RDW levels and all-cause mortality in a non-selected population by a smoothed curve fit plots and COX proportional risk regression models integrating cubic spline functions reported results about a non-linear relationship. In the fully adjusted model, we found that RDW values were positively associated with 30-day, 90-day, 365-day, and 4-year all-cause mortality in 26,818 non-selected adult patients with HRs of 1.10 95%CIs (1.08, 1.12); 1.11 95%CIs (1.10, 1.13); 1.13 95%CIs (1.12, 1.14); 1.13 95%CIs (1.12, 1.14).
In unselected critically ill patients, RDW levels were positively associated with all-cause mortality, with elevated RDW levels increasing all-cause mortality.
尽管红细胞分布宽度(RDW)在临床实践中被广泛观察,但仅有少数研究关注未筛选的危重症患者的全因死亡率,而关于长期死亡率的研究更少。我们研究的目的是通过评估RDW水平来探索未筛选的危重症患者死亡率的预测和推断。
我们使用公开可用的MIMIC-III数据库从未筛选的危重症患者中获取人口统计学信息、实验室检查结果、患病率数据和生命体征。然后,我们使用这些信息,通过Cox比例风险分析、平滑曲线拟合、亚组分析以及未筛选的危重症患者短期、中期和长期全因死亡率的Kaplan-Meier生存曲线,来分析基线RDW水平与未筛选的危重症患者之间的关联。
在按照可接受条件进行筛选后,共有26818例患者纳入我们的研究进行最终数据分析。我们的研究通过平滑曲线拟合图和整合三次样条函数的COX比例风险回归模型,在未选择的人群中研究了RDW水平与全因死亡率之间的关系,报告了非线性关系的结果。在完全调整模型中,我们发现RDW值与26818例未选择的成年患者的30天、90天、365天和4年全因死亡率呈正相关,风险比分别为1.10(95%置信区间为1.08, 1.12);1.11(95%置信区间为1.10, 1.13);1.13(95%置信区间为1.12, 1.14);1.13(95%置信区间为1.12, 1.14)。
在未筛选的危重症患者中,RDW水平与全因死亡率呈正相关,RDW水平升高会增加全因死亡率。