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Chen W, Yu P, Chen C, Cai S, Chen J, Zheng C, Chen C, Zheng L, Guo C. Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database. Ann Lab Med 2024; 44:401-409. [PMID: 38469636 PMCID: PMC11169773 DOI: 10.3343/alm.2023.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/06/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Background Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery. Methods Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan-Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs. Results The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P&0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio=1.17, 95% confidence interval, 1.10-1.25). Our ROC results showed the predictive value of the RDW. Conclusions An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.
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Affiliation(s)
- Weiqiang Chen
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Peiling Yu
- Department of Anaesthesiology, Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Chao Chen
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Shaoyan Cai
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Junheng Chen
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chunqin Zheng
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chaojin Chen
- Department of Anaesthesiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangdong, China
| | - Liangjie Zheng
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chunming Guo
- Department of Anaesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
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Xie X, He K, Zhang Y, Wu J. Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke. Front Neurol 2024; 15:1425633. [PMID: 39188708 PMCID: PMC11345518 DOI: 10.3389/fneur.2024.1425633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Aim To explore the association of Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) with the risk of three-month unfavorable outcomes in acute ischemic stroke (AIS). Methods A secondary analysis was conducted based on a prospective cohort study. A total of 1,889 patients with AIS treated in South Korea from January 2010 to December 2016 were enrolled. Multivariable logistic regression was conducted to investigated the independent relationship between HRR and risk of three-month unfavorable outcomes in AIS. Fitted smoothing curves were used to determine non-linear correlations. The recursive method was employed to explore the turning point and build a two-piece linear regression model. In addition, a set of subgroup analyses were carried out to evaluate the relationship between HRR and risk of three-month unfavorable outcomes. Results Multivariate analysis in which potential confounders were adjusted for indicated that the risk of unfavorable outcomes was reduced by 10% for each unit increased of HRR [OR = 0.90, 95% CI: 0.84-0.96, p = 0.0024]. In addition, a non-linear relationship was observed between HRR and risk of three-month unfavorable outcomes, which had an inflection point of HRR was 10.57. The effect sizes and the confidence intervals on the left side of the inflection point were 0.83 (0.75, 0.91), p = 0.0001. On the right side of the inflection point, no association was found between HRR and the risk of three-month unfavorable outcomes. Conclusion This study demonstrates a negative association between HRR and risk of three-month unfavorable outcomes. The relationship between HRR and risk of three-month unfavorable outcomes is non-linear. The correlation is negative for HRR values less than 10.57. For, HRR higher than 10.57, HRR is not associated with the risk of three-month unfavorable outcomes.
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Affiliation(s)
- Xiaorui Xie
- Department of Neurology, Xiangya Changde Hospital, Changde, Hunan, China
| | - Keli He
- Department of Clinical Laboratory, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, Hunan, China
| | - Yao Zhang
- Department of Clinical Laboratory, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, Hunan, China
| | - Jianhua Wu
- Department of Clinical Laboratory, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, Hunan, China
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Zhang XQ, Shen JH, Zhou Q, Duan XJ, Guo YF. Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis. Medicine (Baltimore) 2024; 103:e38306. [PMID: 38788014 PMCID: PMC11124755 DOI: 10.1097/md.0000000000038306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
We investigated the relationship among red cell distribution width (RDW), to total serum calcium (TSC) ratio (RCR), and in-hospital mortality in patients with acute ischemic stroke (AIS). This study was a retrospective analysis. The data of 2700 AIS patients was retrospectively analyzed from the Medical Information Mart for Intensive Care database (version IV). The main outcome of interest was in-hospital mortality. A Cox proportional hazards regression model was used to determine whether RCR was independently associated with in-hospital mortality. The Kaplan-Meier method was used to plot the survival curves for RCR. Subgroup analyses were performed to measure the mortality across various subgroups. The area under curve (AUC) of receiver operating characteristic curve (ROC) was calculated to ascertain the quality of RCR as a predictor of in-hospital mortality in patients with AIS. In the multivariate analysis, statistically significant differences were identified in age, ethnicity, length of ICU stay, mechanical ventilation, sequential organ failure assessment (SOFA) score, RDW, hemoglobin, RCR, whether taking anticoagulants, hyperlipidemia, and atrial fibrillation (P < .05). A threshold inflection point value of 1.83 was obtained through a two-piecewise regression model. There was a non-linear relationship between RCR and hospital mortality in patients with AIS. The hazard ratio (HR) and the 95% confidence intervals (CI) on the right and left of the inflection point were 0.93 (0.57-1.51; P = .7660) and 2.96 (1.37-6.42; P = .0060), respectively. The Kaplan-Meier curve indicated that survival rates were higher when RCR was ≤ 1.83 and lower when RDW was > 1.83 after adjustment for age, gender, BMI, ethnicity. The area under curve (AUC) of RCR was 0.715. A higher RCR was associated with an increased risk of in-hospital mortality in patients with AIS.
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Affiliation(s)
- Xue-qing Zhang
- Department of Nursing, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Jin-hua Shen
- Department of Nursing, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Xiang-Jie Duan
- Department of Infectious Diseases, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Ya-fen Guo
- Department of Nursing, The First People’s Hospital of Changde City, Changde, People’s Republic of China
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Akyol Gurses A, Akyildiz UO. Predictive value of red cell distribution width for overlap syndrome in obstructive sleep apnea. Front Neurol 2024; 15:1415410. [PMID: 38846032 PMCID: PMC11153708 DOI: 10.3389/fneur.2024.1415410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
Purpose Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are prevalent disorders, and the concurrence so-called overlap syndrome (OVS) is not rare either. Early recognition of OVS is essential because this group is more prone to cardiovascular morbidities and requires effective multidisciplinary follow-up. This study aimed to evaluate RDW in patients with severe OSAS and investigate whether it can predict OVS. Patients and methods 96 patients were retrospectively analyzed, of whom 66 were found to have severe OSAS alone and 30 OVS during diagnostic workups. Demographic, polysomnographic, and laboratory results, including RDW, were compared between groups. Multivariate logistic regression was used to determine independent associates of OVS. Results Gender and body mass index (BMI) were similar, however, the mean age and RDW were higher in the OVS group (p:0.008, p:0.002). The increase in RDW remained significant after adjustment for age, BMI, and cardiovascular risk factors. An RDW value of >13.65% was shown to have a 78.3% sensitivity and 60% specificity for predicting OVS in severe OSAS (p:0.004). Conclusion The results suggest that RDW can be a reliable indicator for diagnosing OVS in OSAS. It can help in identifying the subset of patients who would benefit from proper consultations and multidisciplinary follow-up, leading to appropriate treatment of each disease component and effective monitoring to prevent adverse cardiovascular outcomes.
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Affiliation(s)
- Asli Akyol Gurses
- Division of Clinical Neurophysiology, Department of Neurology, School of Medicine, Gazi University, Ankara, Türkiye
- Neuroscience and Neurotechnology Center of Excellence (NÖROM), Gazi University, Ankara, Türkiye
| | - Utku Ogan Akyildiz
- Department of Neurology, School of Medicine, Adnan Menderes University, Aydin, Türkiye
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Dai J, Guo Y, Zhou Q, Duan XJ, Shen J, Zhang X. The relationship between red cell distribution width, serum calcium ratio, and in-hospital mortality among patients with acute respiratory failure: A retrospective cohort study of the MIMIC-IV database. Medicine (Baltimore) 2024; 103:e37804. [PMID: 38608105 PMCID: PMC11018187 DOI: 10.1097/md.0000000000037804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
To investigate the impact of RDW/CA (the ratio of red cell distribution width to calcium) on in-hospital mortality in patients with acute respiratory failure (ARF). This retrospective cohort study analyzed the data of 6981 ARF patients from the Medical Information Mart for Intensive Care (MIMIC-IV) database 2.0. Critically ill participants between 2008 and 2019 at the Beth Israel Deaconess Medical Center in Boston. The primary outcome of interest was in-hospital mortality. A Cox proportional hazards regression model was used to determine whether the RDW/CA ratio independently correlated with in-hospital mortality. The Kaplan-Meier method was used to plot the survival curves of the RDW/CA. Subgroup analyses were performed to measure the mortality across various subgroups. After adjusting for potential covariates, we found that a higher RDW/CA was associated with an increased risk of in-hospital mortality (HR = 1.17, 95% CI: 1.01-1.35, P = .0365) in ARF patients. A nonlinear relationship was observed between RDW/CA and in-hospital mortality, with an inflection point of 1.97. When RDW/CA ≥ 1.97 was positively correlated with in-hospital mortality in patients with ARF (HR = 1.554, 95% CI: 1.183-2.042, P = .0015). The Kaplan-Meier curve indicated the higher survival rates for RDW/CA < 1.97 and the lower for RDW/CA ≥ 1.97 after adjustment for age, gender, body mass index, and ethnicity. RDW/CA is an independent predictor of in-hospital mortality in patients with ARF. Furthermore, a nonlinear relationship was observed between RDW/CA and in-hospital mortality in patients with ARF.
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Affiliation(s)
- Jun Dai
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, China
| | - Yafen Guo
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, Hunan Province, China
| | - Xiang-Jie Duan
- Department of Infectious Diseases, The First People’s Hospital of Changde City, Changde, Hunan Province, China
| | - Jinhua Shen
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, China
| | - Xueqing Zhang
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, China
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Huang S, Zhang H, Zhuang Z, Guo N, Zhou Q, Duan X, Ge L. Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality. Front Cardiovasc Med 2023; 10:1292153. [PMID: 38169646 PMCID: PMC10758436 DOI: 10.3389/fcvm.2023.1292153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Objective Red 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. Methods This 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. Results A 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. Conclusion The RCR at admission may be useful for predicting in-hospital mortality in ICU-admitted AMI patients.
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Affiliation(s)
- Sulan Huang
- The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Huijia Zhang
- Department of Rheumatology and Immunology, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Zhijie Zhuang
- Department of Gastroenterology, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Ning Guo
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Quan Zhou
- Department of Science and Education Section, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Xiangjie Duan
- Department of Infectious Disease, The First People's Hospital of Changde, Changde City, Hunan Province, China
| | - Liangqing Ge
- The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
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Yao H, Lian L, Zheng R, Chen C. Red blood cell distribution width/platelet ratio on admission as a predictor for in-hospital mortality in patients with acute myocardial infarction: a retrospective analysis from MIMIC-IV Database. BMC Anesthesiol 2023; 23:113. [PMID: 37016294 PMCID: PMC10071654 DOI: 10.1186/s12871-023-02071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator. It integrates the risk prediction of RDW and platelet, which is associated with adverse outcomes. However, the predictive power of RPR in mortality for patients with acute myocardial infarction (AMI) remains uncertain. Thus, we aimed to explore the association between RPR and 180-day in-hospital mortality in patients with AMI. METHODS Data on patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into two groups according to the optimal RPR cut-off value. The survival curve between high and low RPR groups was plotted via the Kaplan-Meier (KM) method. Univariate and multivariate Cox regression analyses were performed to determine the association between RPR on admission and 180-day in-hospital mortality. RESULTS A total of 1266 patients were enrolled, of which 83 (6.8%) died within 180 days during the hospitalization. Compared with the survivor group, the non-survivor group had higher RPR on admission (0.11 ± 0.07 vs. 0.08 ± 0.06, P < 0.001). The KM curve indicated that the survival probability of low RPR group was higher than that of high RPR group. Multivariate Cox regression analysis demonstrated that higher RPR on admission was an independent and effective predictor of 180-day mortality in patients with AMI (hazard ratio [HR]: 2.677, 95% confidence interval [CI]: 1.159-6.188, P = 0.021). CONCLUSION Higher RPR was associated with higher in-hospital 180-day mortality in patients with AMI.
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Affiliation(s)
- Hongxia Yao
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liyou Lian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rujie Zheng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Chen
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Alakare J, Kemp K, Strandberg T, Castrén M, Tolonen J, Harjola VP. Red cell distribution width and mortality in older patients with frailty in the emergency department. BMC Emerg Med 2023; 23:24. [PMID: 36894893 PMCID: PMC9998144 DOI: 10.1186/s12873-023-00801-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The red cell distribution width (RDW) reflects the degree of heterogeneity of red blood cells. Elevated RDW is associated both with frailty and with increased mortality in hospital-admitted patients. In this study we evaluate whether high RDW values are associated with mortality in older emergency department (ED) patients with frailty, and if the association is independent of the degree of frailty. METHODS We included ED patients with the following criteria: ≥ 75 years of age, Clinical Frailty Scale (CFS) score of 4 to 8, and RDW % measured within 48 h of ED admission. Patients were allocated to six classes by their RDW value: ≤ 13%, 14%, 15%, 16%, 17%, and ≥ 18%. The outcome was death within 30 days of ED admission. Crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for a one-class increase in RDW for 30-day mortality were calculated via binary logistic regression analysis. Age, gender and CFS score were considered as potential confounders. RESULTS A total of 1407 patients (61.2% female), were included. The median age was 85 with an inter-quartile range (IQR) of 80-89, median CFS score 6 (IQR: 5-7), and median RDW 14 (IQR: 13-16). Of the included patients, 71.9% were admitted to hospital wards. A total of 85 patients (6.0%) died during the 30-day follow-up. Mortality rate was associated with RDW increase (p for trend < .001). Crude OR for a one-class increase in RDW for 30-day mortality was 1.32 (95% CI: 1.17-1.50, p < .001). When adjusted for age, gender and CFS-score, OR of mortality for one-class RDW increase was still 1.32 (95% CI: 1.16-1.50, p < .001). CONCLUSION Higher RDW values had a significant association with increased 30-day mortality risk in frail older adults in the ED, and this risk was independent of degree of frailty. RDW is a readily available biomarker for most ED patients. It might be beneficial to include it in risk stratification of older frail ED patients to identify those who could benefit from further diagnostic assessment, targeted interventions, and care planning.
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Affiliation(s)
- Janne Alakare
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. .,Department of Geriatric Acute Care, Espoo Hospital, 2550 02070, City of Espoo, PL, Finland.
| | - Kirsi Kemp
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - Maaret Castrén
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jukka Tolonen
- Department of Internal Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Veli-Pekka Harjola
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Mert İlker H, Faysal S, Ahmet Çağdaş Y, Murat S, Tufan Ç. Prognostic value of Intermountain Risk Score for short- and long-term mortality in patients with cardiogenic shock. Coron Artery Dis 2023; 34:154-159. [PMID: 36720024 DOI: 10.1097/mca.0000000000001219] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is a lack of current research examining the predictive value of the Intermountain Risk Score (IMRS) in patients with ST-segment elevation myocardial infarction (STEMI) caused by cardiogenic shock. Therefore, the purpose of this research was to investigate the ability of IMRS to predict short- and long-term mortality in patients with cardiogenic shock triggered by STEMI. METHODS The participants included 492 consecutive cardiogenic shock patients who underwent primary percutaneous coronary intervention following STEMI. The patients were separated into two groups depending on their survival status. The groups' baseline characteristics, laboratory data, echocardiographic variables, and risk assessments were then compared. Next, the IMRS score was tested for its ability to predict both short- and long-term mortality. In order to assess its accuracy, the prognostic value of the IMRS was also compared that of the SYNTAX score II (SSII). RESULTS After adjustment for the characteristics in the univariable study, multivariable Cox regression analysis indicated that the IMRS and SSII were both independently associated with short- and long-term mortality in STEMI patients with cardiogenic shock. However, the receiver operating characteristic curves indicated that the IMRS outperformed the SSII in terms of predicting both short- and long-term mortality. CONCLUSION This preliminary investigation showed that IMRS can predict both short- and long-term mortality in individuals with STEMI accompanied by cardiogenic shock.
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Affiliation(s)
- Hayiroğlu Mert İlker
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul
| | - Saylik Faysal
- Department of Cardiology, Van Training and Research Hospital, Van
| | - Yumurtaş Ahmet Çağdaş
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul
| | - Selçuk Murat
- Department of Cardiology, Haydarpasa Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Çinar Tufan
- Department of Cardiology, Haydarpasa Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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10
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Karanadze NA, Begrambekova YL, Borisov EN, Orlova YA. [Red cell distribution width as a predictor of impaired exercise capacity in patients with heart failure]. KARDIOLOGIIA 2022; 62:30-35. [PMID: 35569161 DOI: 10.18087/cardio.2022.4.n1813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/29/2021] [Indexed: 06/15/2023]
Abstract
Aim To test a hypothesis that increased values of red cell distribution width (RDW) in patients with chronic heart failure (CHF) can be related with low exercise tolerance.Material and methods 102 patients were evaluated who had CHF with mid-range and reduced left ventricular ejection fraction (LV EF) without anemia (72% men, mean age 66±10.2 years). Cardiopulmonary stress test (CPST), echocardiography, 6‑min walk test (6MWT), blood count, and measurements of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and serum iron were performed.Results The average LV EF was 39±8.7 %; the peak oxygen consumption (VO2peak) was 13.7±4.8 ml /kg /min; and the median NT-pro-BNP was 595.3 pg /ml (Q1-3 1443-2401). RDW variables, including the RDW coefficient of variation (RDW-CV) and RDW standard deviation (RDW-SD), were not significantly related with serum iron or hemoglobin concentrations. A one-factor linear regression analysis showed a significant correlation of VO2peak with RDW-SD (р=0.039). A multivariate linear regression analysis with adjustments for LV EF, hemoglobin concentration, and age did not reveal any significant correlation of VO2peak with RDW variables. The distance covered in the 6MWT was significantly associated with RDW-CV both in the one-factor analysis and with adjustments for LV EF, hemoglobin and serum iron concentrations, and age.Conclusion This study showed that high RDW values in CHF patients without anemia predicted low exercise tolerance regardless of the age, LV systolic function, and hemoglobin and serum iron concentrations. A 16% increase in RDW-CV significantly decreased the likelihood of covering a distance longer than 360 m during 6 min.
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Affiliation(s)
- N A Karanadze
- Medical Research and Educational Center, Lomonosov Moscow State University; Faculty of Fundamental Medicine, Lomonosov Moscow State University
| | - Yu L Begrambekova
- Medical Research and Educational Center, Lomonosov Moscow State University; Faculty of Fundamental Medicine, Lomonosov Moscow State University
| | - E N Borisov
- Medical Research and Educational Center, Lomonosov Moscow State University; Faculty of Fundamental Medicine, Lomonosov Moscow State University
| | - Ya A Orlova
- Medical Research and Educational Center, Lomonosov Moscow State University; Faculty of Fundamental Medicine, Lomonosov Moscow State University
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McBurney MI, Tintle NL, Harris WS. Omega-3 index is directly associated with a healthy red blood cell distribution width. Prostaglandins Leukot Essent Fatty Acids 2022; 176:102376. [PMID: 34839221 DOI: 10.1016/j.plefa.2021.102376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022]
Abstract
Low red blood cell (RBC) membrane content of EPA and DHA, i.e., the omega-3 index (O3I), and elevated RBC distribution width (RDW) are risk factors for all-cause mortality. O3I and RDW are related with membrane fluidity and deformability. Our objective was to determine if there is a relationship between O3I and RDW in healthy adults. Subjects without inflammation or anemia, and with values for O3I, RDW, high-sensitivity C-reactive protein (CRP), body mass index (BMI), age and sex were identified (n = 25,485) from a clinical laboratory dataset of > 45,000 individuals. RDW was inversely associated with O3I in both sexes before and after (both p < 0.00001) adjusting models for sex, age, BMI and CRP. Stratification by sex revealed a sex-O3I interaction with the RDW-O3I slope (p < 0.00066) being especially steep in females with O3I ≤ 5.6%. In healthy adults of both sexes, the data suggested that an O3I of > 5.6% may help maintain normal RBC structural and functional integrity.
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Affiliation(s)
- Michael I McBurney
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; Division of Biochemical and Molecular Biology, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, United States of America.
| | - Nathan L Tintle
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Department of Population Health Nursing Science, College of Nursing, University of Illinois - Chicago, Chicago, IL 60612, United States of America
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, United States of America
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Red blood cell distribution width to platelet ratio substantiates preoperative survival prediction in patients with newly-diagnosed glioblastoma. J Neurooncol 2021; 154:229-235. [PMID: 34347223 PMCID: PMC8437903 DOI: 10.1007/s11060-021-03817-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
Object The conception of individual patient-adjusted treatment strategies is constantly emerging in the field of neuro-oncology. Systemic laboratory markers may allow insights into individual needs and estimated treatment benefit at an earliest possible stage. Therefore, the present study was aimed at analyzing the prognostic significance of preoperative routine laboratory values in patients with newly-diagnosed glioblastoma. Methods Between 2014 and 2019, 257 patients were surgically treated for newly-diagnosed glioblastoma at the Neuro-Oncology Center of the University Hospital Bonn. Preoperative routine laboratory values including red blood cell distribution width (RDW) and platelet count were reviewed. RDW to platelet count ratio (RPR) was calculated and correlated to overall survival (OS) rates. Results Median preoperative RPR was 0.053 (IQR 0.044–0.062). The receiver operating characteristic (ROC) curve indicated an optimal cut-off value for RPR to be 0.05 (AUC 0.62; p = 0.002, 95% CI 0.544–0.685). 101 patients (39%) presented with a preoperative RPR < 0.05, whereas 156 patients (61%) had a RPR ≥ 0.05. Patients with preoperative RPR < 0.05 exhibited a median OS of 20 months (95% CI 17.9–22.1), which was significantly higher compared to a median OS of 13 months (95% CI 10.9–15.1) in patients with preoperative RPR ≥ 0.05 (p < 0.001). Conclusions The present study suggests the RPR to constitute a novel prognostic inflammatory marker for glioblastoma patients in the course of preoperative routine laboratory examinations and might contribute to a personalized medicine approach.
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