.Clinical value of the red blood cell distribution width to albumin ratio in the assessment of prognosis in critically ill patients with sepsis: a retrospective analysis.

Ma, C; Liang, G; Wang, B; Eisenhut , M; Urrechaga, E; Wiedermann , C.J; Andaluz-Ojeda , D; O'Rourke, J; Zhang, Z; Jin , X; Zhong, X

.Clinical value of the red blood cell distribution width to albumin ratio in the assessment of prognosis in critically ill patients with sepsis: a retrospective analysis.

Authors

Ma, C

Liang, G

Wang, B

Eisenhut , M

Urrechaga, E

Wiedermann , C.J

Andaluz-Ojeda , D

O'Rourke, J

Zhang, Z

Jin , X

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Issue Date

2024

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Surgery::Surgical research::Thoracic surgery

Abstract

Abstract Background: Red blood cell (RBC) distribution width (RDW) to albumin ratio is a novel biomarker and its prognostic effect on critically ill patients with sepsis has not been extensively investigated. The objective of this study was to identify the prognostic value of the RDW to albumin ratio in these patients. Methods: Data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. A Cox proportional hazards model and restricted cubic spline model were used to determine the association of RDW to albumin ratio with mortality. Receiver operating characteristic (ROC) curves and Kaplan-Meier survival curves were applied, and the area under the curve (AUC) was used to compare the predictive value. Results: A total of 3,969 eligible patients were enrolled. The median RDW to albumin ratio was significantly higher in non-survivors than in survivors at 30 and 90 days. Patients were divided into groups according to the RDW to albumin ratio, and the risk of 30- and 90-day mortality markedly increased in the group with a higher ratio. The relationship between the RDW to albumin ratio as a continuous variable and 30-day mortality also showed an upward trend in the restricted cubic spline. The AUC of the RDW to albumin ratio was 0.633 in discriminating 30-day mortality which was similar to that of the lactate to albumin ratio (AUC =0.617; P=0.133) and higher than that of the neutrophil percentage to albumin ratio (AUC =0.559; P<0.001). Conclusions: The RDW to albumin ratio is a promising biomarker for assessing the prognosis of critically ill patients with sepsis. Its predictive value in determining mortality was found to be similar to that of the lactate to albumin ratio and superior to that of the neutrophil percentage to albumin ratio. Keywords: Sepsis; albumin; prognosis; red blood cell distribution width (RDW). 2024 Journal of Thoracic Disease. All rights reserved. PubMed Disclaimer Conflict of interest statement Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1696/coif). C.J.W. reports fees for speaking and/or consulting from Biotest, CSL Behring, and Grifols. The other authors have no conflicts of interest to declare. Figures Figure 1 Figure 1 Flowchart of patients enrolled from… Figure 2 Figure 2 Comparison of RDW to albumin… Figure 3 Figure 3 The association between RDW to… Figure 4 Figure 4 Adjusted HR and 95% CI… Figure 5 Figure 5 Prognostic value of indicators for… Figure 6 Figure 6 Kaplan-Meier survival curve at 30… References Machado FR, Cavalcanti AB, Bozza FA, et al. The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infect Dis 2017;17:1180-9. 10.1016/S1473-3099(17)30322-5 - DOI - PubMed Xie J, Wang H, Kang Y, et al. The Epidemiology of Sepsis in Chinese ICUs: A National Cross-Sectional Survey. Crit Care Med 2020;48:e209-18. 10.1097/CCM.0000000000004155 - DOI - PubMed Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801-10. 10.1001/jama.2016.0287 - DOI - PMC - PubMed Duncan CF, Youngstein T, Kirrane MD, et al. Diagnostic Challenges in Sepsis. Curr Infect Dis Rep 2021;23:22. 10.1007/s11908-021-00765-y - DOI - PMC - PubMed Zheng YJ, Zhu XJ, Chen YW, et al. Establishment of a novel risk score for in-hospital mortality in adult sepsis patients. Ann Transl Med 2022;10:781. 10.21037/atm-21-2900 - DOI - PMC - PubMed Show all 41 references Related information MedGen LinkOut - more resources Full Text Sources AME Publishing Company Europe PubMed Central PubMed Central

Citation

Ma C, Liang G, Wang B, Eisenhut M, Urrechaga E, Wiedermann CJ, Andaluz-Ojeda D, O'Rourke J, Zhang Z, Jin X, Zhong X. Clinical value of the red blood cell distribution width to albumin ratio in the assessment of prognosis in critically ill patients with sepsis: a retrospective analysis. J Thorac Dis. 2024 Jan 30;16(1):516-529. doi: 10.21037/jtd-23-1696. Epub 2024 Jan 10. PMID: 38410549; PMCID: PMC10894361.