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Zhou G, Yang L, Lu Y, Lu G. Prognostic value of hemoglobin to red blood cell distribution width ratio in pancreatic ductal adenocarcinoma: a retrospective study. BMC Gastroenterol 2024; 24:288. [PMID: 39192176 DOI: 10.1186/s12876-024-03381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 08/22/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Previous studies have identified the hemoglobin (Hb) to red blood cell distribution width (RDW) ratio (HRR) is associated with the prognosis of a variety of malignant tumors. However, the relationship between HRR and pancreatic ductal adenocarcinoma (PDAC) prognosis remains unexplored. This study aims to ascertain the prognostic significance of HRR in PDAC patients. METHODS In a retrospective analysis, 128 PDAC patients undergoing initial surgical resection at Ningbo Medical Center Lihuili Hospital between January 2016 and September 2021 were included. Based on receiver operating characteristic curve-derived cut-off values, participants were categorized into low and high HRR groups. The correlation between HRR and patient prognosis was subsequently examined. RESULTS Significant disparities in age, Hb levels, RDW, tumor locality, surgical intervention, and postoperative chemotherapy were observed between the two groups (P < 0.05). Notably, the low HRR cohort exhibited inferior disease-free survival (DFS) and overall survival (OS) rates (P = 0.002 for both). Univariate analysis indicated that male gender, adjacent tissue invasion, TNM stages III/IV, non-O blood types, low HRR, and lack of postoperative chemotherapy were linked to adverse DFS and OS outcomes (P < 0.05). Multivariate analysis further delineated low HRR as an independent predictor of poor DFS and OS outcomes (HR: 1.520, 95% CI: 1.028-2.247, P = 0.036; HR: 1.537, 95% CI: 1.034-2.284, P = 0.034, respectively). CONCLUSION Our findings suggest that a lower HRR is indicative of poorer DFS and OS in PDAC patients, underscoring its potential utility as a prognostic biomarker for this population.
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Affiliation(s)
- Guanbao Zhou
- Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Liang Yang
- Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Yangfang Lu
- Department of Radiotherapy, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Genjie Lu
- Department of Blood Transfusion, Ningbo Medical Center Lihuili Hospital, Ningbo University, 1111 Jiangnan road, Ningbo, 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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Yuan X, Zeng W, Wang H, Shu G, Wu C, Nie M, Wang J, Chen S. Predictive value of the early postoperative hemoglobin-to-red blood cell distribution width ratio for acute kidney injury in elderly intertrochanteric fracture patients. BMC Musculoskelet Disord 2024; 25:630. [PMID: 39113005 PMCID: PMC11308471 DOI: 10.1186/s12891-024-07745-y] [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: 12/31/2023] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Hemoglobin-to-red blood cell distribution width ratio (HRR) had great predictive value for the prognosis of malignant tumors and cardiovascular disease. However, its predictive value for the occurrence of acute kidney injury (AKI) in elderly intertrochanteric fracture patients remains unclear. This study aims to analyze the correlation between the early postoperative HRR and the risk of postoperative AKI in elderly intertrochanteric fracture patients. METHODS We reviewed the medical records of 307 elderly intertrochanteric fracture patients in this single-center retrospective cohort study. We performed univariate analysis on the relevant parameters, and parameters with significant differences were included in the following logistic regression model for multivariate analysis. Then, we used a receiver operating characteristic (ROC) curve to evaluate the predictive value of the early postoperative HRR level for AKI in elderly intertrochanteric fracture patients. Patients were divided into a high HRR group and a low HRR group according to the cutoff point determined by ROC curve analysis. Subsequently, the relevance between postoperative HRR and AKI was further determined using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). RESULTS The area under the curve of the early postoperative HRR for predicting postoperative AKI was 0.714 (95% CI: 0.618-0.809). The cutoff value was 5.44. The sensitivity was 72.7%, and the specificity was 70.8%. Patients were divided into low HRR (⩽ 5.44) and high HRR (> 5.44) groups according to the cutoff value. PSM and IPTW analysis indicated that the risk of AKI in the low HRR group was significantly higher than that in the high HRR group in both the matched cohort (OR = 6.914, 95% CI: 1.714-46.603, p = 0.016) and the weighted group (OR = 2.784, 95% CI: 1.415-5.811, p = 0.040). CONCLUSIONS Early postoperative HRR is an accurate, accessible, and economical blood test parameter that can predict the risk of postoperative AKI in elderly patients with femoral intertrochanteric fracture.
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Affiliation(s)
- Xin Yuan
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Wang Zeng
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Hao Wang
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Guoyin Shu
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Chen Wu
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Ming Nie
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China
| | - Jiao Wang
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China.
| | - Shirong Chen
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Linjiang road No.76, Yuzhong District, Chongqing, 400010, China.
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Meischl T, Balcar L, Park YR, Bucher L, Meier P, Suhr Y, Pomej K, Mandorfer M, Reiberger T, Trauner M, Scheiner B, Pinter M. Anaemia is independently associated with mortality in patients with hepatocellular carcinoma. ESMO Open 2024; 9:103593. [PMID: 38848660 PMCID: PMC11214999 DOI: 10.1016/j.esmoop.2024.103593] [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: 01/30/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Anaemia is frequent in patients with cancer and/or liver cirrhosis and is associated with impaired quality of life. Here, we investigated the impact of anaemia on overall survival (OS) and clinical characteristics in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS HCC patients treated between 1992 and 2018 at the Medical University of Vienna were retrospectively analysed. Anaemia was defined as haemoglobin level <13 g/dl in men and <12 g/dl in women. RESULTS Of 1262 assessable patients, 555 (44.0%) had anaemia. The main aetiologies of HCC were alcohol-related liver disease (n = 502; 39.8%) and chronic hepatitis C (n = 375; 29.7%). Anaemia was significantly associated with impaired liver function, portal hypertension, more advanced Barcelona Clinic Liver Cancer stage and elevated C-reactive protein (CRP). In univariable analysis, anaemia was significantly associated with shorter median OS [9.5 months, 95% confidence interval (95% CI) 7.3-11.6 months] versus patients without anaemia (21.5 months, 95% CI 18.3-24.7 months) (P < 0.001). In multivariable analysis adjusted for age, Model for End-stage Liver Disease, number of tumour nodules, size of the largest nodule, macrovascular invasion, extrahepatic spread, first treatment line, alpha-fetoprotein and CRP, anaemia remained an independent predictor of mortality (adjusted hazard ratio 1.23, 95% CI 1.06-1.43, P = 0.006). CONCLUSIONS Anaemia was significantly associated with mortality in HCC patients, independent of established liver- and tumour-related prognostic factors. Whether adequate management of anaemia can improve outcome of HCC patients needs further evaluation.
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Affiliation(s)
- T Meischl
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Liver Cancer (HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; 3(rd) Medical Department (Haematology & Oncology), Hanusch-Krankenhaus, Vienna, Austria
| | - L Balcar
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Liver Cancer (HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - Y-R Park
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - L Bucher
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - P Meier
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - Y Suhr
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - K Pomej
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Liver Cancer (HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - M Mandorfer
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - T Reiberger
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria
| | - M Trauner
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - B Scheiner
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Liver Cancer (HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna
| | - M Pinter
- Division of Gastroenterology und Hepatology, Department of Medicine III, Medical University of Vienna, Vienna; Liver Cancer (HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna.
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Zhao WX, Wu ZY, Zhao N, Diao YP, Lan Y, Li YJ. Novel Systemic Inflammatory Markers Predict All-Cause Mortality in Patients Undergoing Endovascular Abdominal Aortic Aneurysm Repair. Rev Cardiovasc Med 2024; 25:202. [PMID: 39076323 PMCID: PMC11270096 DOI: 10.31083/j.rcm2506202] [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: 11/10/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 07/31/2024] Open
Abstract
Background Clinically useful predictors for risk stratification of long-term survival may assist in selecting patients for endovascular abdominal aortic aneurysm (EVAR) procedures. This study aimed to analyze the prognostic significance of peroperative novel systemic inflammatory markers (SIMs), including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), hemoglobin-to-red cell distribution width ratio (HRR), systemic immune-inflammatory index (SIII), and systemic inflammatory response index (SIRI), for long-term mortality in EVAR. Methods A retrospective analysis was performed on 147 consecutive patients who underwent their first EVAR procedure at the Department of Vascular Surgery, Beijing Hospital. The patients were divided into the mortality group (n = 37) and the survival group (n = 110). The receiver operating characteristic curves were used to ascertain the threshold value demonstrating the most robust connection with mortality. The Kaplan-Meier survival analysis was performed between each SIM and mortality. The relationship between SIMs and survival was investigated using restricted cubic splines and multivariate Cox regression analysis. Results The study included 147 patients, with an average follow-up duration of 34.28 ± 22.95 months. Deceased patients showed significantly higher NLR (p < 0.001) and reduced HRR (p < 0.001). The Kaplan-Meier estimates of mortality were considerably greater in the higher-NLR group (NLR > 2.77) and lower-HRR group (HRR < 10.64). The hazard ratio (HR) of 0.833 (95% confidence interval (95% CI): 0.71-0.97, p < 0.021) was determined to be statistically significant in predicting death in the multivariable analysis. Conclusions Preoperative higher-NLR and lower-HRR have been associated with a lower long-term survival rate in abdominal aortic aneurysm (AAA) patients undergoing elective EVAR. Multivariate Cox regression showed that decreased preoperative HRR is an independent risk factor that increases mortality risk following EVAR. SIMs, such as the NLR and HRR, could be used in future clinical risk prediction methodologies for AAA patients undergoing EVAR. However, additional prospective cohort studies are needed to identify these findings.
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Affiliation(s)
- Wen-Xin Zhao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, 100010 Beijing, China
| | - Zhi-Yuan Wu
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
| | - Ning Zhao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, 100010 Beijing, China
| | - Yong-Peng Diao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, 100010 Beijing, China
| | - Yong Lan
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, 100010 Beijing, China
| | - Yong-Jun Li
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, 100010 Beijing, China
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Nakamura N, Tsunemine H, Ikunari R, Tanaka Y, Arima N. Red blood cell distribution width is a useful biomarker to predict bleeding and thrombosis risks in patients with immune thrombocytopenic purpura. EJHAEM 2024; 5:431-439. [PMID: 38895062 PMCID: PMC11182403 DOI: 10.1002/jha2.897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 06/21/2024]
Abstract
Bleeding and thrombosis are common complications during immune thrombocytopenic purpura (ITP) treatment. There is a strong need to predict bleeding and thrombosis risks before ITP treatment to optimize therapy and appropriately manage these complications. We performed a retrospective cohort study of 120 patients with primary ITP to identify a biomarker to predict bleeding and thrombosis. We compared blood test results at diagnosis between patients with and without bleeding or thrombosis episodes. The standard deviation of red blood cell distribution width (RDW-SD) differed significantly between those with and without bleeding and between those with and without thrombosis, leading us to identify it as a variable representative of risk. RDW-SD was significantly associated with patient age and with histories of several vascular diseases. Multivariate regression analyses showed that RDW integrated several variables associated with vascular risks. RDW-SD was significantly associated with difficulty with corticosteroid discontinuation (hazard ratio [HR], 2.22, p = 0.01), incidence of bleeding (HR, 2.75, p< 0.01), incidence of thrombosis (HR, 2.67, p< 0.01) and incidence of infection (HR, 1.78, p = 0.04). The RDW-SD value at the time of ITP diagnosis is a useful biomarker to predict the risks of bleeding, thrombosis, and other complications.
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Affiliation(s)
- Naokazu Nakamura
- Department of HematologyShinko HospitalKobeJapan
- Department of Hematology and OncologyGraduate School of MedicineKyoto UniversityKyotoJapan
| | | | - Ryo Ikunari
- Department of HematologyShinko HospitalKobeJapan
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Yetişir A, Sariyildiz A, Türk İ, Coskun Benlidayi I. Evaluation of inflammatory biomarkers and the ratio of hemoglobin-red cell distribution width in patients with rheumatoid arthritis treated with tumor necrosis factor-alpha inhibitors. Clin Rheumatol 2024; 43:1815-1821. [PMID: 38622428 DOI: 10.1007/s10067-024-06963-y] [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: 01/17/2024] [Revised: 03/15/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The aim of this study was to examine pre-treatment and post-treatment hemogram-derived inflammatory biomarkers in patients with rheumatoid arthritis (RA) who received anti-tumor necrosis factor (TNF)-α treatment. MATERIAL AND METHODS The data of 1182 patients with RA were screened. Among them, 207 patients who met the eligibility criteria were included in the retrospective study. Demographic parameters, disease activity, and blood cell-derived indexes were evaluated. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and hemoglobin-red cell distribution width (Hb/RDW) rates were evaluated before treatment and at the third month of treatment in patients with RA who received anti-TNF-α treatment. RESULTS According to the EULAR response criteria, 12.6% of the 207 patients responded to anti-TNF-α treatment as none, 21.3% as good, and 66.2% as moderate, respectively. Post-treatment NLR and PLR values were significantly lower than pre-treatment values (p < 0.001), whereas post-treatment LMR and Hb/RDW values were significantly higher than pre-treatment values (respectively, p = 0.001 and p = 0.012). The difference between pre-treatment and post-treatment values of LMR and Hb/RDW was significantly higher when compared to the moderate + good response groups than the none-response group (p = 0.002 and p = 0.014, respectively). However, in the receiver operating characteristic curve analysis, these parameters were not found to be significant in predicting treatment response. CONCLUSION Significant changes were detected in hemogram-derived inflammatory markers of the groups responding to anti-TNF-α treatment. They can be used as a guide during treatment follow-up. Yet, they do not predict treatment response. Key Points • RA may manifest with periods of remission and activation, and regular follow-up is essential. • There is a demand for readily available, reproducible, and cost-effective parameters to assess treatment response. • Hemogram-derived inflammatory markers differ in relation to anti-TNF-α treatment response in RA. • None of those markers demonstrate an acceptable predictive performance in distinguishing patients based on their response to TNF-α inhibitors.
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Affiliation(s)
- Ayşegül Yetişir
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Aylin Sariyildiz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - İpek Türk
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey
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Wu W, Lu W, Hong D, Yu X, Xiong L. Association Between Hemoglobin-Albumin-Lymphocyte-Platelet Index and Mortality in Hospitalized COVID-19 Omicron BA.2 Infected Patients. Infect Drug Resist 2024; 17:1467-1476. [PMID: 38628242 PMCID: PMC11020245 DOI: 10.2147/idr.s451613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
Background The hemoglobin-albumin-lymphocyte-platelet (HALP) index is a novel biomarker reflecting systemic inflammation and nutritional status which are important for coronavirus disease 2019 (COVID-19) mortality. However, the association between HALP and mortality in patients with COVID-19 has yet to be investigated. Methods A cohort of COVID-19 Omicron BA.2 infected patients admitted to the Shanghai Fourth People's Hospital, School of Medicine, Tongji University from April 12, 2022 to June 17, 2022 was retrospectively analyzed. Laboratory examinations on hospital admission, including hemoglobin, albumin, and lymphocyte and platelet, were collected. The association between baseline HALP and in-hospital poor overall survival (OS) was assessed using Kaplan-Meier curves, Cox regression models, interaction, and stratified analyses. Results A total of 2147 patients with COVID-19 Omicron BA.2 infection were included in the final analyses, and mortality in the hospital was 2.65%. Multivariate analysis indicated that low HALP index was independently associated with in-hospital mortality of COVID-19 patients [hazard ratio (HR) = 2.08; 95% confidence interval (CI) = 1.17-3.73]. Subgroup analysis demonstrated that low HALP index was an independent risk factor for in-hospital mortality in COVID-19 patients with age ≥70 (HR = 2.22, CI = 1.18-4.15) and severe cases (HR = 2.09, CI = 1.13-3.86). Conclusion HALP index is independently related to in-hospital poor OS for COVID-19 Omicron BA.2 infected patients, especially for age ≥70 and severe cases. HALP index on hospital admission is a useful candidate biomarker for identifying high risk of mortality in COVID-19 Omicron BA.2 infected patients.
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Affiliation(s)
- Wei Wu
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434, People’s Republic of China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
| | - Wenbin Lu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, PLA, Shanghai, 200433, People’s Republic of China
| | - Dongmei Hong
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434, People’s Republic of China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
| | - Xiya Yu
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434, People’s Republic of China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
| | - Lize Xiong
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434, People’s Republic of China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
- Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434, People’s Republic of China
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Zhong L, Zhong Y, Chen W, Liang F, Liao Y, Zhou Y. Association between haemoglobin-to-red blood cell distribution width ratio at admission and all-cause mortality in adult patients with sepsis in an intensive care unit: a secondary analysis of the MIMIC-IV database. BMJ Open 2024; 14:e081340. [PMID: 38553061 PMCID: PMC10982791 DOI: 10.1136/bmjopen-2023-081340] [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: 10/26/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE The association between haemoglobin-to-red blood cell distribution width ratio (HRR) and all-cause mortality remains poorly understood. This study aimed to examine the influence of HRR at the time of admission mortality over 1 year and 30 days in patients with sepsis. DESIGN This was a secondary analysis. SETTING This study was conducted in intensive care units (ICUs). PARTICIPANTS Adult patients with sepsis were identified and included from an intensive care database based on eligibility criteria. PRIMARY OUTCOME AND MEASURE The primary outcome was the rate of death within 1 year. The secondary outcome was the death rate within 30 days. RESULTS A total of 4233 patients with sepsis who met the inclusion criteria were analysed, excluding those ineligible. These participants were divided into quartiles based on their HRR at admission. The overall mortality rates at 1 year and 30 days were 42.9% and 25.5%, respectively. A significant inverse association was observed between HRR quartiles and all-cause mortality (p<0.001). Pairwise comparisons using Kaplan-Meier analysis showed significant differences in 1-year mortality rates across the quartiles. However, no significant difference was detected in 30-day mortality between the Q3 and Q4 groups (p=0.222). Multivariate Cox regression analysis demonstrated that a higher HRR at ICU admission was independently associated with reduced mortality at 1 year (HR, 0.935; 95% CI 0.913 to 0.958; p<0.001) and 30 days (HR, 0.969; 95% CI 0.939 to 0.999; p=0.043). Furthermore, restricted cubic spline models indicated a non-linear relationship between HRR and mortality at both 1 year and 30 days (p<0.001 for both). CONCLUSIONS This retrospective analysis demonstrated that the HRR at the time of admission was a significant prognostic marker for long-term mortality in patients with sepsis.
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Affiliation(s)
- Liping Zhong
- Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Yuting Zhong
- Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Weiming Chen
- Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Fei Liang
- Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Yilin Liao
- Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Yuanjun Zhou
- Meizhou People's Hospital, Meizhou, Guangdong, China
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Lizeth ANM, Vanessa BV, María Del Rocio TB, Margarita FC, Damián JM, Alfredo CO, Edgar CE, Placido RF. Hepatoprotective Effect Assessment of C-Phycocyanin on Hepatocellular Carcinoma Rat Model by Using Photoacoustic Spectroscopy. APPLIED SPECTROSCOPY 2024; 78:296-309. [PMID: 38224996 DOI: 10.1177/00037028231222508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Hepatocellular carcinoma (HCC) is the most common primary neoplasia of the liver with elevated mortality. Experimental treatment with antioxidants has a beneficial effect on the experimental models of HCC. Arthrospira maxima (spirulina) and its phycocyanin have antitumoral action on different tumoral cells. However, it is unknown whether phycocyanin is the responsible molecule for the antitumoral effect on HCC. Photoacoustic spectroscopy (PAS) stands out among other spectroscopy techniques for its versatility of samples analyzed. This technique makes it possible to obtain the optical absorption spectrum of solid or liquid, dark or transparent samples. Previous studies report that assessing liver damage in rats produced by the modified resistant hepatocyte model (MRHM) is possible by analyzing their blood optical absorption spectrum. This study aimed to investigate, by PAS, the effect of phycocyanin obtained from spirulina on hepatic dysfunction. The optical absorption spectra analysis of the rat blood indicates the damage level induced by the MRHM group, being in concordance with the carried out biological conventional studies results, indicating an increase in the activity of hepatic enzymes, oxidative stress, Bax/Bcl2 ratio, cdk2, and AKT2 expression results, with a reduction in p53 expression. Also, PAS results suggest that phycocyanin decreases induced damage, due to the prevention of the Bax, AKT2, and p53 altered expression and the tumor progression in a HCC rat model.
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Affiliation(s)
- Alvarado-Noguez Margarita Lizeth
- Departamento de Física, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Col. San Pedro Zacatenco, Ciudad de México, México
| | - Blas-Valdivia Vanessa
- Laboratorio de Neurobiología, Departamento de Fisiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Alcaldía Gustavo A. Madero, Ciudad de México, México
| | - Thompson-Bonilla María Del Rocio
- Laboratorio de Medicina Genómica, Hospital Regional 1ro de Octubre, ISSSTE, Alcaldía Gustavo A. Madero, Ciudad de México, México
| | - Franco-Colín Margarita
- Laboratorio de Metabolismo I. Departamento de Fisiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Colonia Unidad Profesional Adolfo López Mateos, Alcaldía Gustavo A. Madero., Ciudad de México, México
| | - Jacinto-Méndez Damián
- Departamento de Física, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Col. San Pedro Zacatenco, Ciudad de México, México
| | - Cruz-Orea Alfredo
- Departamento de Física, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Col. San Pedro Zacatenco, Ciudad de México, México
| | - Cano-Europa Edgar
- Laboratorio de Neurobiología, Departamento de Fisiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Alcaldía Gustavo A. Madero, Ciudad de México, México
| | - Rojas-Franco Placido
- Laboratorio de Metabolismo I. Departamento de Fisiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Colonia Unidad Profesional Adolfo López Mateos, Alcaldía Gustavo A. Madero., Ciudad de México, México
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Lin Q, Liao J, Dong W, Zhou F, Xu Y. The relationship between hemoglobin/red blood cell distribution width ratio and mortality in patients with intracranial hemorrhage: a possible protective effect for the elderly? Intern Emerg Med 2023; 18:2301-2310. [PMID: 37740867 DOI: 10.1007/s11739-023-03431-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
Intracranial hemorrhage (ICH) is a neurological emergency with a poor prognosis. This study aimed to understand the association between hemoglobin levels, red blood cell distribution width ratio (HRR), and mortality in patients with ICH. Information on patients with ICH was extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Cox proportional risk models were used to assess the relationship between HRR and 28-day and 90-day mortality, and constructed by adjusting for relevant covariates. Segmented regression models and smoothing curves were used to analyze the linear relationship between HRR and mortality. This study recruited 4,716 patients with ICH. The HRR Q4 group was negatively associated with the 28- and 90-day mortality. For patients aged > 65 years, the right-hand threshold inflection points of the HRR were 0.92 and 0.93, respectively, which were negatively associated with 28-day mortality (HR:0.06, 95% CI 0.01, 0.35, p = 0.0016) and with 90-day mortality (p = 0.0006). In the non-linear model, both 28-day mortality (HR, 0.17; 95% CI 0.04-0.75, p = 0.0191; HRR > 0.89) and 90-day mortality (HR, 0.13; 95% CI 0.04-0.49, p = 0.0022; HRR > 0.85) were associated in men. In the subgroup analysis, the negative association between HRR and mortality was more pronounced in patients > 65 years of age, as well as in patients with non-dementia, diabetes, and malignant cancer. We found a non-linear relationship between mortality and the HRR in elderly patients, and a higher HRR was negatively associated with mortality in patients with ICH.
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Affiliation(s)
- QianXia Lin
- Vascular Breast Surgery, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China
- The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - JinPing Liao
- Department of Infectious Diseases, Jiujiang First People's Hospital, Jiujiang, 330006, Jiangxi, China
| | - WeiHua Dong
- The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Medical Security Division, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, People's Republic of China
| | - Fang Zhou
- Vascular Breast Surgery, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China.
- The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
| | - Yun Xu
- The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
- Medical Security Division, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, People's Republic of China.
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Li K, Yan J, Zhang H. Correlation between peripheral blood hemoglobin/erythrocyte distribution width ratio and prognosis of patients with primary colorectal cancer. Medicine (Baltimore) 2023; 102:e34031. [PMID: 37335638 DOI: 10.1097/md.0000000000034031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
The prognostic value of peripheral blood hemoglobin/red blood cell distribution width ratio (HRR) in colorectal cancer (CRC) is unclear. The aim of this study was to analyze the correlation between peripheral blood HRR and the prognosis of CRC. A retrospective study analyzed the medical records of 284 CRC patients who attended Linyi People Hospital between June 1, 2017 and June 1, 2021. The optimal diagnostic cutoff value for hemoglobin (Hb)/erythrocyte distribution width was determined by ROC curve as 3.098, and patients were divided into high- and low-level groups for comparative analysis of clinical data. Kaplan-Meier method was used for survival analysis, and logrank test was used to assess survival differences. In univariate and multifactorial analyses, Cox proportional risk regression models were used to assess independent risk factors for overall survival (OS) and progression-free survival (PFS). All statistical tests were bilateral probability tests with α = 0.05, and P < .05 was considered statistically significant. There were 284 patients who were finally included in the statistical analysis. Gender, tumor stage, Hb, platelets, and CEA were associated with PFS and OS. Tumor stage, Hb, and HRR (P < .05) were independent risk factors for PFS and OS. Low-level HRR was associated with poor patient prognosis. Low-level HRR is associated with poor patient prognosis and is a potential tumor prognostic marker.
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Affiliation(s)
- Kang Li
- Department of General Surgery, Linyi People's Hospital, Linyi, Shandong Province, China
| | - Jing Yan
- Department of General Surgery, Linyi People's Hospital, Linyi, Shandong Province, China
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Haifeng Zhang
- Department of General Surgery, Linyi People's Hospital, Linyi, Shandong Province, China
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