Zhang Kai, Han Yu, Gao Yu Xuan, Gu Fang Ming, Cai Tianyi, Hu Rui, Gu Zhao Xuan, Liang Jia Ying, Zhao Jia Yu, Gao Min, Li Bo, Cui Dan
Cardiovascular Surgery Department Second Hospital of Jilin University, Changchun, China.
Department of Ophthalmology First Hospital of Jilin University, Changchun, China.
Crit Care Res Pract. 2024 Jul 29;2024:9562200. doi: 10.1155/2024/9562200. eCollection 2024.
Elevated red blood cell distribution width (RDW) levels are strongly associated with an increased risk of mortality in patients with congestive heart failure (CHF). Additionally, heart failure has been closely linked to diabetes. Nevertheless, the relationship between RDW and in-hospital mortality in the intensive care unit (ICU) among patients with both congestive heart failure (CHF) and diabetes mellitus (DM) remains uncertain.
This retrospective study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, a comprehensive critical care repository. RDW was assessed as both continuous and categorical variables. The primary outcome of the study was in-hospital mortality at the time of hospital discharge. We examined the association between RDW on ICU admission and in-hospital mortality using multivariable logistic regression models, restricted cubic spline analysis, and subgroup analysis.
The cohort consisted of 7,063 patients with both DM and CHF (3,135 females and 3,928 males). After adjusting for potential confounders, we found an association between a 9% increase in mortality rate and a 1 g/L increase in RDW level (OR = 1.09; 95% CI, 1.05∼1.13), which was associated with 11 and 58% increases in mortality rates in Q2 (OR = 1.11, 95% CI: 0.87∼1.43) and Q3 (OR = 1.58, 95% CI: 1.22∼2.04), respectively, compared with that in Q1. Moreover, we observed a significant linear association between RDW and in-hospital mortality, along with strong stratified analyses to support the findings.
Our findings establish a positive association between RDW and in-hospital mortality in patients with DM and CHF.
红细胞分布宽度（RDW）升高与充血性心力衰竭（CHF）患者的死亡风险增加密切相关。此外，心力衰竭与糖尿病也密切相关。然而，充血性心力衰竭（CHF）和糖尿病（DM）患者在重症监护病房（ICU）的RDW与院内死亡率之间的关系仍不确定。
这项回顾性研究使用了重症监护医学信息数据库IV（MIMIC-IV）的数据，这是一个综合性的重症监护资料库。RDW被评估为连续变量和分类变量。该研究的主要结局是出院时的院内死亡率。我们使用多变量逻辑回归模型、受限立方样条分析和亚组分析来研究ICU入院时的RDW与院内死亡率之间的关联。
该队列包括7063例同时患有DM和CHF的患者（3135例女性和3928例男性）。在调整潜在混杂因素后，我们发现RDW水平每升高1 g/L，死亡率增加9%（OR = 1.09；95% CI，1.05∼1.13），与第一四分位数（Q1）相比，第二四分位数（Q2）（OR = 1.11，95% CI：0.87∼1.43）和第三四分位数（Q3）（OR = 1.58，95% CI：1.22∼2.04）的死亡率分别增加11%和58%。此外，我们观察到RDW与院内死亡率之间存在显著的线性关联，并进行了强有力的分层分析以支持这些发现。
我们的研究结果表明，RDW与DM和CHF患者的院内死亡率之间存在正相关。
