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血红蛋白(Hb)、红细胞分布宽度(RDW)及其联合指标对急性主动脉夹层患者短期和长期死亡率的相关性及预测价值

The correlation and predictive value of Hb, RDW and their association for short-term and long-term mortality in patients with acute aortic dissection.

作者信息

Hou Peng, Xia Lin, Xin Fangran, Sun Boxuan, Zhang Guoxin, Yu Liming, Wang Huishan

机构信息

Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.

65052 troops, The Chinese People's Liberation Army, Taonan, Jilin, China.

出版信息

Front Cardiovasc Med. 2025 Jan 6;11:1444498. doi: 10.3389/fcvm.2024.1444498. eCollection 2024.

Abstract

BACKGROUND

This study examines the relationship between Hb, RDW and their association and both short-term and long-term mortality in patients with acute aortic dissection (AAD), aiming to establish combined effect between Hb and RDW as a potential prognostic biomarker for AAD outcomes.

METHODS

We extracted clinical data from the Medical Information Mart for Intensive Care (MIMIC) databases for this analysis. Using adjusted Cox regression and Kaplan-Meier survival curve analyses, we assessed the relationship between Hb, RDW and their association at admission and mortality at multiple post-discharge intervals (30 days, 90 days, 1 year, and 5 years) among patients with AAD. Additionally, subgroup analyses and receiver operating characteristic (ROC) curve analyses were conducted to evaluate the predictive accuracy of Hb, RDW and their association for mortality in this patient population.

RESULTS

High RDW combined with low Hb (RDW ≥ 13.60 and Hb < 7.9) significantly predicted increased mortality at 30 days, 90 days, 1 year, and 5 years post-diagnosis, with hazard ratios (HRs) as follows: 4.33 (95% CI: 1.82-10.33,  < 0.001), 4.48 (95% CI: 2.06-9.77,  < 0.001), 3.38 (95% CI: 1.70-6.70,  < 0.001), and 3.07 (95% CI: 1.66-5.66,  < 0.001), respectively.

CONCLUSION

Hb and RDW are both abnormal (Hb with low level, RDW with high level) is positively correlated with 30 days, 90 days, 1 year, and 5 years mortality risk in patients with AAD. This suggests that combined effect between Hb and RDW is a significant predictor of short-term to long-term mortality risk in this patient population, highlighting its potential utility as a prognostic marker in clinical settings.

摘要

背景

本研究探讨急性主动脉夹层(AAD)患者血红蛋白(Hb)、红细胞分布宽度(RDW)及其联合与短期和长期死亡率之间的关系,旨在确定Hb和RDW的联合效应作为AAD预后潜在生物标志物的作用。

方法

我们从重症监护医学信息数据库(MIMIC)中提取临床数据进行分析。通过调整后的Cox回归和Kaplan-Meier生存曲线分析,我们评估了AAD患者入院时Hb、RDW及其联合与出院后多个时间间隔(30天、90天、1年和5年)死亡率之间的关系。此外,进行了亚组分析和受试者工作特征(ROC)曲线分析,以评估Hb、RDW及其联合对该患者群体死亡率的预测准确性。

结果

高RDW合并低Hb(RDW≥13.60且Hb<7.9)显著预测诊断后30天、90天、1年和5年死亡率增加,风险比(HR)如下:分别为4.33(95%CI:1.82-10.33,<0.001)、4.48(95%CI:2.06-9.77,<0.001)、3.38(95%CI:1.70-6.70,<0.001)和3.07(95%CI:1.66-5.66,<0.001)。

结论

Hb和RDW均异常(Hb水平低,RDW水平高)与AAD患者30天、90天、1年和5年死亡风险呈正相关。这表明Hb和RDW的联合效应是该患者群体短期至长期死亡风险的重要预测指标,凸显了其在临床环境中作为预后标志物的潜在效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed41/11743433/0ea575eece02/fcvm-11-1444498-g001.jpg

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