Department of Pathology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Laboratory Medicine & Central Laboratory, Southern Medical University Affiliated Fengxian Hospital, Shanghai, China.
PLoS One. 2024 May 15;19(5):e0302414. doi: 10.1371/journal.pone.0302414. eCollection 2024.
Investigating the association between red cell distribution width (RDW) and all-cause mortality in patients with breast cancer, to evaluate the potential clinical prognostic value of RDW.
Based on the RDW index, patients with breast cancer in the Medical Information Mart for Intensive Care (MIMIC-IV) database were categorized into quartiles. The primary outcomes included in-hospital mortality from all causes during the first six months, the first year, and the first three years. Cox hazards regression and restricted cubic spline (RCS) models were developed to investigate the effects of RDW on primary outcomes.
The study included 939 patients (female). The 6-month, 1-year, and 3-year mortality rates were 14.0%, 21.4%, and 28.4%, respectively. Multivariate Cox proportional hazards analyses demonstrated that RDW exhibited an autonomous association with an increased risk of all-cause mortality. After adjusting for confounders, higher RDW quartiles were significantly associated with 6-month mortality (adjusted hazard ratio (HR), 3.197; 95% confidence interval (CI), 1.745-5.762; P < 0.001), 1-year mortality (adjusted HR, 2.978; 95% CI, 1.867-4.748; P < 0.001), and 3-year mortality (adjusted HR, 2.526; 95% CI, 1.701-3.750; P < 0.001). The RCS curves demonstrated that high RDW (> 14.6) was associated with a greater risk of all-cause mortality. Subgroup analyses revealed no statistically significant differences in the interactions between the subgroups.
The study revealed a highly pronounced relationship between RDW and overall mortality, indicating its potential as an autonomous prognostic factor for increased mortality among patients with breast cancer.
探讨红细胞分布宽度（RDW）与乳腺癌患者全因死亡率之间的关系，评估 RDW 的潜在临床预后价值。
基于 RDW 指数，将 MIMIC-IV 数据库中的乳腺癌患者分为四组。主要结局包括前 6 个月、前 1 年和前 3 年的全因院内死亡率。采用 Cox 比例风险回归和限制立方样条（RCS）模型探讨 RDW 对主要结局的影响。
该研究纳入了 939 名女性患者。6 个月、1 年和 3 年的死亡率分别为 14.0%、21.4%和 28.4%。多变量 Cox 比例风险分析表明，RDW 与全因死亡风险增加具有自主相关性。在调整混杂因素后，较高的 RDW 四分位组与 6 个月死亡率（调整后的危险比（HR），3.197；95%置信区间（CI），1.745-5.762；P < 0.001）、1 年死亡率（调整后的 HR，2.978；95%CI，1.867-4.748；P < 0.001）和 3 年死亡率（调整后的 HR，2.526；95%CI，1.701-3.750；P < 0.001）显著相关。RCS 曲线表明，高 RDW（>14.6）与全因死亡率增加相关。亚组分析显示，亚组间无统计学显著的交互作用。
该研究揭示了 RDW 与总体死亡率之间的高度显著关系，表明其作为乳腺癌患者死亡率增加的自主预后因素具有潜在价值。
