Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Soochow University, Changzhou, 23000, China.
Department of Respiratory and Critical Care Medicine, Changzhou Fourth People's Hospital, Changzhou, 23000, China.
BMC Med Inform Decis Mak. 2024 Sep 13;24(1):253. doi: 10.1186/s12911-024-02639-4.
The association between red blood cell distribution width (RDW) to albumin ratio (RAR) and prognosis in patients with acute respiratory failure (ARF) admitted to the Intensive Care Unit (ICU) remains unclear. This retrospective cohort study aims to investigate this association.
Clinical information of ARF patients was collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 2.0 database. The primary outcome was, in-hospital mortality and secondary outcomes included 28-day mortality, 60-day mortality, length of hospital stay, and length of ICU stay. Cox regression models and subgroup analyses were conducted to explore the relationship between RAR and mortality.
A total of 4547 patients with acute respiratory failure were enrolled, with 2277 in the low ratio group (RAR < 4.83) and 2270 in the high ratio group (RAR > = 4.83). Kaplan-Meier survival analysis demonstrated a significant difference in survival probability between the two groups. After adjusting for confounding factors, the Cox regression analysis showed that the high RAR ratio had a higher hazard ratio (HR) for in-hospital mortality (HR 1.22, 95% CI 1.07-1.40; P = 0.003), as well as for 28-day mortality and 60-day mortality. Propensity score-matched (PSM) analysis further supported the finding that high RAR was an independent risk factor for ARF.
This study reveals that RAR is an independent risk factor for poor clinical prognosis in patients with ARF admitted to the ICU. Higher RAR levels were associated with increased in-hospital, 28-day and 60-day mortality rates.
红细胞分布宽度（RDW）与白蛋白比值（RAR）与入住重症监护病房（ICU）的急性呼吸衰竭（ARF）患者的预后之间的关系尚不清楚。本回顾性队列研究旨在探讨这种相关性。
从医疗信息汇总分析与重症监护第四版（MIMIC-IV）版本 2.0 数据库中收集 ARF 患者的临床信息。主要结局是住院死亡率，次要结局包括 28 天死亡率、60 天死亡率、住院时间和 ICU 住院时间。采用 Cox 回归模型和亚组分析探讨 RAR 与死亡率之间的关系。
共纳入 4547 例急性呼吸衰竭患者，其中低比值组（RAR<4.83）2277 例，高比值组（RAR≥4.83）2270 例。Kaplan-Meier 生存分析显示两组间生存概率存在显著差异。在调整混杂因素后，Cox 回归分析显示高 RAR 比值与住院死亡率（HR 1.22，95%CI 1.07-1.40；P=0.003）以及 28 天和 60 天死亡率具有更高的危险比（HR）。倾向评分匹配（PSM）分析进一步支持了高 RAR 是 ARF 的独立危险因素的发现。
本研究表明，RAR 是入住 ICU 的 ARF 患者临床预后不良的独立危险因素。较高的 RAR 水平与住院、28 天和 60 天死亡率增加相关。
