基于MIMIC-III数据库的急性胰腺炎患者入院时红细胞分布宽度与白蛋白比值与全因死亡率的关系。
Association between red blood cell distribution width-to-albumin ratio at admission and all-cause mortality in patients with acute pancreatitis based on the MIMIC-III database.
作者信息
Wu Qingsong, Liao Lianyi, Deng Qingjun
机构信息
Department of Critical Care Medicine, Chongqing Red Cross Hospital (People's Hospital of Jiangbei District), Chongqing, China.
Department of Scientific Research and Education, Chongqing Red Cross Hospital (People's Hospital of Jiangbei District), Chongqing, China.
出版信息
PLoS One. 2025 Feb 7;20(2):e0318873. doi: 10.1371/journal.pone.0318873. eCollection 2025.
OBJECTIVE
The association between red blood cell distribution width-to-albumin (RDW/ALB) ratio (RAR) and all-cause mortality in patients with acute pancreatitis has not been fully delineated. The purpose of this study was to investigate the impact of RAR at admission on 28-day all-cause mortality in patients with acute pancreatitis.
DESIGN
This investigation was conducted as a retrospective analysis utilizing data from the Medical Information Mart for Intensive Care (MIMIC)-III database.
PARTICIPANTS
Patients with acute pancreatitis were selected from the MIMIC-III database according to predefined eligibility criteria.
OUTCOME
The outcome was the all-cause mortality rates within 28 days.
RESULTS
Upon screening and excluding ineligible participants, a total of 931 patients with acute pancreatitis who met the inclusion criteria were analyzed. The overall mortality at 28 days was 11.71%. The receiver operating characteristic (ROC) analysis indicated that RAR had a moderate predictive value for all-cause mortality at 28 days, with an area under the curve (AUC) of 0.669 (95%CI, 0.617-0.720; p<0.05), and the cutoff value was 4.39. Divide the patients into a high RAR group and a low RAR group based on the cutoff value. Kaplan-Meier survival analysis demonstrated a statistically significant increase in 28-day mortality among patients in the high RAR group compared to those in the low RAR group. Multivariate analysis indicated that potassium levels, total bilirubin, blood urea nitrogen, lactate, partial thromboplastin time, neutrophil and RAR were independently associated with the 28-day mortality. Multivariate Cox regression analysis confirmed that an elevated RAR was independently associated with increased mortality at 28 day (HR, 2.72; 95% CI, 1.64-4.52; p < 0.001).
CONCLUSIONS
This study demonstrated that RAR at admission functioned as a significant prognostic indicator for mortality in patients with acute pancreatitis.
目的
红细胞分布宽度与白蛋白（RDW/ALB）比值（RAR）与急性胰腺炎患者全因死亡率之间的关联尚未完全阐明。本研究旨在探讨入院时RAR对急性胰腺炎患者28天全因死亡率的影响。
设计
本研究采用回顾性分析方法，利用重症监护医学信息数据库（MIMIC）-III中的数据。
研究对象
根据预先设定的纳入标准，从MIMIC-III数据库中选取急性胰腺炎患者。
观察指标
观察指标为28天内的全因死亡率。
结果
经过筛选和排除不符合条件的参与者，共分析了931例符合纳入标准的急性胰腺炎患者。28天的总体死亡率为11.71%。受试者工作特征（ROC）分析表明，RAR对28天全因死亡率具有中等预测价值，曲线下面积（AUC）为0.669（95%CI，0.617-0.720；p<0.05），截断值为4.39。根据截断值将患者分为高RAR组和低RAR组。Kaplan-Meier生存分析表明，高RAR组患者28天死亡率较低于RAR组有统计学显著升高。多因素分析表明，血钾水平、总胆红素、血尿素氮、乳酸、活化部分凝血活酶时间、中性粒细胞和RAR与28天死亡率独立相关。多因素Cox回归分析证实，RAR升高与28天死亡率增加独立相关（HR，2.72；95%CI，1.64-4.52；p<0.001）。
结论
本研究表明，入院时的RAR是急性胰腺炎患者死亡率的重要预后指标。
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