Relationship between the red cell distribution width-to-platelet ratio and in-hospital mortality among critically ill patients with acute myocardial infarction: a retrospective analysis of the MIMIC-IV database

Li, Tong; Liu, Yan-Qiong; Shen, Jin; O, Min B; Zhou, Quan; Duan, Xiangjie; Guo, Ya Fen; Zhang, Xue Qing

doi:10.1136/bmjopen-2022-062384

Cited by 6 publications

(3 citation statements)

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“…The RDW reflects the inflammation level. Inflammatory reactions play a significant role in AMI occurrence and progression, which may lead to an elevation in RDW ( 8 , 27 , 28 ).We believe that the RDW can be used to predict the prognosis of AMI patients because it reflects the level of inflammation. Similarly, serum Ca level is an independent predictor of in-hospital death in patients with ST elevation myocardial infarction (STEMI) ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality

Huang,

Zhang,

Zhuang

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveRed cell distribution width (RDW) and serum calcium (Ca) levels are predictors of in-hospital mortality in acute myocardial infarction (AMI) patients. However, their sensitivity and specificity are limited. Therefore, this study aimed to determine whether the RDW to Ca ratio (RCR) acquired on admission can be used to predict the in-hospital mortality of AMI patients.MethodsThis retrospective cohort study extracted clinical information from the Medical Information Market for Intensive IV (MIMIC-IV) database on 2,910 AMI patients enrolled via propensity score matching (PSM). Prognostic values were assessed using a multivariate logistic model and three PSM approaches. Analysis was performed based on stratified variables and interactions among sex, age, ethnicity, anemia, renal disease, percutaneous transluminal coronary intervention (PCI), coronary artery bypass grafting (CABG), atrial fibrillation, congestive heart failure, dementia, diabetes, paraplegia, hypertension, cerebrovascular disease, and Sequential Organ Failure Assessment (SOFA) score.ResultsA total of 4,105 ICU-admitted AMI patients were analyzed. The optimal cut-off value of the RCR for in-hospital mortality was 1.685. The PSM was performed to identify 1,455 pairs (2,910) of score-matched patients, with balanced differences exhibited for nearly all variables.The patients’ median age was 72 years (range, 63–82 years) and 60.9% were male. The risk of in-hospital mortality incidence increased with increasing RCR levels. After adjusting for confounders, the risk ratio for the incidence of in-hospital mortality for high RCR was 1.75 [95% confidence interval (CI): 1.60–1.94, P = 0.0113] compared to that associated with low RCR in the PSM cohort. High RCR was also substantially implicated in in-hospital mortality incidence in the weighted cohorts [odds ratio (OR) = 1.76, 95% CI: 1.62–1.94, P = 0.0129]. Assessment of RCR in three groups showed that patients with high RCR also had a higher risk of in-hospital mortality (OR = 3.04; 95% CI, 2.22–4.16; P < 0.0001) than in patients with RCR in the adjusted model. In the sensitivity analysis, both the original and weighted groups showed similar results.ConclusionThe RCR at admission may be useful for predicting in-hospital mortality in ICU-admitted AMI patients.

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Section: Discussionmentioning

confidence: 99%

Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality

Huang,

Zhang,

Zhuang

et al. 2023

Front. Cardiovasc. Med.

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“…The RDW-to-platelet ratio (RPR) is a novel composite parameter that comprehensively reflects the role of RDW and platelet count in several diseases. RPR, a potential indicator of inflammatory processes, has already been established as a prognostic factor in numerous other diseases [13][14][15][16][17][18][19]. Considering the key role of inflammation in the pathophysiology of AIS, RPR may be associated with the prognosis of patients with AIS.…”

Section: Introductionmentioning

confidence: 99%

Red Cell Distribution Width-to-Platelet Count Ratio: A Promising Predictor of In-Hospital All-Cause Mortality in Critically Ill Patients with Acute Ischemic Stroke

Xie

Duan

et al. 2023

Cerebrovasc Dis

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Introduction: The red blood cell distribution width-to-platelet ratio (RPR), a novel inflammatory index, has already been proven as a prognostic factor in some other diseases, but its prognostic effect on critically ill patients with acute ischemic stroke (AIS) has been rarely investigated. This study aimed to investigate the association between RPR and in-hospital mortality in these patients. Methods: We extracted clinical data from the Medical Information Mart for Intensive Care IV 1.0 database. The primary outcome was in-hospital all-cause mortality of patients with critical AIS. The main independent variable was RPR. To investigate the association between RPR and in-hospital all-cause mortality in patients with critical AIS, multivariable logistic analyses, smooth curve fitting, and stratified analyses were conducted. Results: In total, 2,673 patients with AIS who were admitted to the intensive care unit were included in the study. In the multivariable analysis, in-hospital mortality was positively related to RPR (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.02–1.59). According to the two-piecewise logistic regression model, we found that the inflection point of RPR was 1.89%. To the left of the inflection point (RPR ≤1.89%), we did not detect any relationship between RPR and in-hospital all-cause mortality (OR [95% CI]: 0.73 [0.41, 1.31], p = 0.2884). In contrast, to the right of the inflection point (RPR >1.89%), RPR was positively related to in-hospital all-cause mortality (OR [95% CI]: 1.61 [1.18, 2.19], p = 0.0027). Conclusions: RPR showed a nonlinear relationship with in-hospital all-cause mortality in patients with critical AIS.

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“…In most studies, composite indicators are better than singlecharacteristic indicators. According to Tong et al, 33 RDW-to-platelet ratio is an independent predictor of in-hospital mortality in AMI patients. In our study, the RAR predicted in-hospital mortality in AMI patients in the ICU better…”

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Red Cell Distribution Width/Albumin Ratio: A Predictor of In-Hospital All-Cause Mortality in Patients with Acute Myocardial Infarction in the ICU

Jian¹,

Zhang²,

Zhou³

et al. 2023

IJGM

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Red cell distribution width (RDW) and albumin level are linked to adverse outcomes in patients with acute myocardial infarction (AMI). Nonetheless, it remains unknown whether the RDW/albumin ratio (RAR) is associated with the short-term prognosis of AMI. Using a large cohort, we aimed to explore the association between RAR and in-hospital all-cause mortality in intensive care unit (ICU) patients with AMI. Patients and Methods: The patients' data analyzed in this retrospective cohort investigation were obtained from the eICU Collaborative Research Data Resource. RAR was calculated based on the serum albumin level and RDW. The primary outcome was in-hospital all-cause mortality. Receiver operating characteristic curve, multiple logistic regression model, and Kaplan-Meier survival analysis were performed to explore the prognostic value of RAR. Results: We enrolled 2594 patients in this study. After correcting for confounding factors, the RAR was an independent predictor for in-hospital mortality in our model (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.12, 1.43). A similar relationship was observed with mechanical ventilation use. RAR showed a better predictive value with an area under the curve (AUC) of 0.738 (cutoff, 4.776) for in-hospital all-cause mortality compared to RDW or albumin alone. Kaplan-Meier estimator curve analyses for RAR demonstrated that the group with RAR ≥4.776%/g/dL had poorer survival than the group with RAR <4.776%/g/dL (p< 0.0001). The subgroup analysis revealed no significant interaction between RAR and in-hospital all-cause mortality in all strata. Conclusion: RAR was an independent risk factor for in-hospital all-cause mortality in ICU patients with AMI. Higher RAR values corresponded to higher mortality rates. RAR is a more accurate predictor of in-hospital all-cause mortality in patients with AMI in the ICU than albumin or RDW. Thus, RAR may be a potential biomarker of AMI.

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Relationship between the red cell distribution width-to-platelet ratio and in-hospital mortality among critically ill patients with acute myocardial infarction: a retrospective analysis of the MIMIC-IV database

Cited by 6 publications

References 49 publications

Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality

Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality

Red Cell Distribution Width-to-Platelet Count Ratio: A Promising Predictor of In-Hospital All-Cause Mortality in Critically Ill Patients with Acute Ischemic Stroke

Red Cell Distribution Width/Albumin Ratio: A Predictor of In-Hospital All-Cause Mortality in Patients with Acute Myocardial Infarction in the ICU

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