Department of Emergency-Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Turk J Gastroenterol. 2024 Aug 2;35(8):651-664. doi: 10.5152/tjg.2024.24067.
To investigate the relationship between hemoglobin-to-red blood cell distribution width (RDW) ratio (HRR) and the 30-day mortality risk in acute pancreatitis (AP), and assess the predictive ability of HRR. Data from 2001 to 2019 in the Medical Information Mart for Intensive Care-III/IV (MIMIC-III/IV) were analyzed. The outcome of this retrospective cohort study was 30-day mortality. Hemoglobin-to-RDW ratio (0-24 hours) and HRR (24-48 hours) were divided into 4 groups based on quartiles (Q1, Q2, Q3, and Q4). The predictive effect was evaluated by the C-index. A total of 1736 patients were included, and 30-day mortality occurred in 204 (11.75%) patients. Compared with Q1 of HRR (0-24 hours), Q2 (HR = 0.60, 95% CI : 0.42-0.86), Q3 (HR =0.47, 95% CI : 0.31-0.71), and Q4 (HR = 0.45, 95% CI : 0.29-0.68) of HRR levels reduced the 30-day mortality risk. Hemoglobin-to-RDW ratio (24-48 hours) was consistent with the results of HRR (0-24 hours). For changes in HRR, Q4 for changes in HRR levels (HR = 1.64, 95% CI : 1.09-2.45) increased the 30-day mortality risk. Hemoglobin-toRDW ratio significantly improved the predictive effect of Sequential Organ Failure Assessment (C-index = 0.736) and Bedside Index of Severity in Acute Pancreatitis (C-index = 0.704) on 30-day mortality. Higher HRR levels reduced the 30-day mortality risk in AP and may improve the prediction of other tools.
为了研究血红蛋白与红细胞分布宽度比（HRR）与急性胰腺炎（AP）30 天死亡率之间的关系，并评估 HRR 的预测能力，我们对 2001 年至 2019 年期间医疗信息监测 III/IV 版（MIMIC-III/IV）中的数据进行了分析。本回顾性队列研究的结局为 30 天死亡率。根据四分位数（Q1、Q2、Q3 和 Q4）将血红蛋白与红细胞分布宽度比（0-24 小时）和 HRR（24-48 小时）分为 4 组。通过 C 指数评估预测效果。共纳入 1736 例患者，其中 204 例（11.75%）患者在 30 天内死亡。与 HRR（0-24 小时）的 Q1 相比，HRR 水平的 Q2（HR=0.60，95%CI：0.42-0.86）、Q3（HR=0.47，95%CI：0.31-0.71）和 Q4（HR=0.45，95%CI：0.29-0.68）降低了 30 天死亡率风险。血红蛋白与红细胞分布宽度比（24-48 小时）与 HRR（0-24 小时）的结果一致。对于 HRR 的变化，HRR 水平变化的 Q4（HR=1.64，95%CI：1.09-2.45）增加了 30 天死亡率风险。血红蛋白与红细胞分布宽度比显著提高了序贯器官衰竭评估（C 指数=0.736）和急性胰腺炎床边严重程度指数（C 指数=0.704）对 30 天死亡率的预测效果。较高的 HRR 水平降低了 AP 的 30 天死亡率风险，并且可能改善了其他工具的预测效果。
