Weng Chao, Yu Cong, Yang Guang-Wei, Jiang Jin-Song, Wu Hao
Department of Vascular Surgery, General Surgery, Cancer Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40785. doi: 10.1097/MD.0000000000040785.
To explore whether red blood cell distribution width-albumin ratio (RAR) is relevant to in-hospital mortality among abdominal aortic aneurysm (AAA). This is a retrospective study retrieving data from the MIMIC-IV database. Patients were divided into survivor or non-survivor groups by the in-hospital mortality. Receiver operating characteristic curve analysis, logistic regression models, subgroup analysis, interaction analysis, and restricted cubic spline analysis were conducted to analyze the correlation between RAR and in-hospital mortality. Then, we divided patients into 2 groups by an optimal cutoff value of RAR to identify the factors independently linked to RAR. Following this, the mediation analysis was conducted to reveal the potential regulatory path. Finally, we assessed the clinical value of RAR in secondary outcomes containing length of hospital stay, intensive care unit (ICU) admission, and ICU stay. Totally 770 participants with AAA were enrolled: 722 survivors and 48 non-survivors. Higher RAR was observed in the non-survivor group and its level performed satisfactorily in predicting in-hospital mortality. AAA patients were more likely to die during in-hospital with the increase of RAR (P < .05) and this linear correlation was revealed by restricted cubic spline (P non-linear > .05). Additionally, urea nitrogen and creatinine were independently related to RAR. RAR served as a mediator in the association of urea nitrogen/creatinine with in-hospital mortality. Finally, the length of hospital stay and ICU stay were longer in the RAR ≥ 4.658 group (P < .05). RAR is a potential risk predictor for in-hospital mortality in AAA patients. Further, RAR upregulation was significantly correlated with prolonged length of hospital stay and ICU stay.
探讨红细胞分布宽度与白蛋白比值（RAR）是否与腹主动脉瘤（AAA）患者的院内死亡率相关。这是一项从MIMIC-IV数据库中检索数据的回顾性研究。根据院内死亡率将患者分为存活组或非存活组。进行受试者工作特征曲线分析、逻辑回归模型、亚组分析、交互分析和限制性立方样条分析，以分析RAR与院内死亡率之间的相关性。然后，我们根据RAR的最佳截断值将患者分为两组，以确定与RAR独立相关的因素。在此之后，进行中介分析以揭示潜在的调节途径。最后，我们评估了RAR在包括住院时间、重症监护病房（ICU）入住率和ICU住院时间等次要结局中的临床价值。共纳入770例AAA患者：722例存活者和48例非存活者。在非存活组中观察到较高的RAR水平，其在预测院内死亡率方面表现良好。随着RAR的增加，AAA患者在院内死亡的可能性更大（P < 0.05），并且限制性立方样条分析显示了这种线性相关性（P非线性> 0.05）。此外，尿素氮和肌酐与RAR独立相关。RAR在尿素氮/肌酐与院内死亡率的关联中起中介作用。最后，RAR≥4.658组的住院时间和ICU住院时间更长（P < 0.05）。RAR是AAA患者院内死亡率的潜在风险预测指标。此外，RAR上调与住院时间延长和ICU住院时间延长显著相关。
