| Shu Zhang,Shan Xu,Rui Liao,Kaixiu Qin. The correlation between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in patients with malignant tumors and sepsis: A retrospective cohort study using the MIMIC-IV database. Oncol Transl Med, 2023, 9: 73-81. |
| The correlation between the hemoglobin-to-red cell distribution width ratio and all-cause mortality in patients with malignant tumors and sepsis: A retrospective cohort study using the MIMIC-IV database |
| Received:April 01, 2023 Revised:May 03, 2023 |
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| KeyWord:Hemoglobin-to-red cell distribution width ratio (HRR); malignant tumors; sepsis; prognosis; the Medical Information Mart for Intensive Care (MIMIC)-IV |
| Author Name | Affiliation | E-mail | | Shu Zhang | Department of Hepatological Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400013, China | 125074265@qq.com | | Shan Xu | Department of Emergency, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China | 601421954@qq.com | | Rui Liao | Department of Hepatological Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400013, China | | | Kaixiu Qin | Department of Emergency, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China | |
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| Abstract: |
| Objective: The aim of the study was to investigate the correlation between the hemoglobin-to-red cell
distribution width ratio (HRR) and all-cause mortality in patients with malignant tumors and sepsis.
Methods: All patients who met the inclusion criteria of the Medical Information Mart for Intensive Care
(MIMIC)-IV were selected and divided into four groups according to the quartile range of HRR distribution.
Kaplan-Meier (K-M) analysis was used to plot the 28-day survival curve, and the log-rank test was used
to compare the prognosis in each HRR group. A Cox proportional hazards regression model was used to
evaluate the prognosis of HRR as both a continuous and categorical variable, and a restricted cubic spline
was used to study the effect of HRR, as a continuous variable, on the mortality in patients with malignant
tumors and sepsis. Interaction and subgroup analyses were performed to evaluate the consistency of
correlations.
Results: A total of 3926 patients were included in the study, including 934 patients in the HRR ≤ 4.97
group, 988 patients in the 4.97 < HRR ≤ 6.26 group, 1005 patients in the 6.26 < HRR ≤ 7.84 group, and
999 patients in the HRR ≥ 7.84 group. According to the K-M analysis, the 28-day survival rate was the
lowest in the HRR ≤ 4.97 group (59.53%), and there were significant differences in survival rates among
different HRR levels (P < 0.001). The Cox proportional hazards regression model found that after adjusting
for various potential confounding factors, HRR was negatively correlated with 28-day and 365-day mortality,
and the risk of death in the HRR ≥ 7.84 group was significantly lower than that in the HRR ≤ 4.97 group
(P = 0.030 and P = 0.008, respectively). The restricted cubic spline plot revealed a linear and negative
relationship between the HRR and the 28-day and 365-day mortality rates. Subgroup analysis revealed an
interaction between HRR, blood urea nitrogen, and SAPS II scores (P = 0.010 and P = 0.048, respectively).
Conclusion: Low HRR is an independent risk factor for all-cause mortality in patients with malignant
tumors and sepsis and could be used as a prognostic indicator for these patients. |
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