| 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. |
| 血红蛋白-红细胞分布宽度比值与恶性肿瘤合并脓毒症患者全因死亡率的相关性 ——一项基于MIMIC-Ⅳ数据库的回顾性研究 |
| 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 |
| DOI：10.1007/s10330-023-0637-7 |
| 中文关键词: 血红蛋白-红细胞分布宽度比值；恶性肿瘤；脓毒症；MIMIC-Ⅳ |
| 英文关键词: Hemoglobin-to-red cell distribution width ratio (HRR); malignant tumors; sepsis; prognosis; the Medical Information Mart for Intensive Care (MIMIC)-IV |
| 基金项目: |
| 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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| 中文摘要: |
| 目的：探讨血红蛋白与红细胞分布宽度比（hemoglobin-to-red cell distribution width ratio, HRR）与恶性肿瘤合并脓毒症患者全因死亡率之间的相关性。方法：选择重症监护医学信息集市（Mart for Intensive Care, MIMIC）-IV数据库中所有符合纳入标准的患者作为研究对象，并根据HRR四分位数分布情况将其分为四组。Kaplan-Meier分析用于绘制28天生存曲线，Log-rank检验用于比较各HRR组患者的预后。通过Cox比例风险回归模型确定HRR作为连续变量和分类变量时对预后的预测价值，并使用多因素Cox回归的限制性立方样条来研究HRR作为连续变量对恶性肿瘤合并脓毒症患者死亡率的影响。采用亚组分析来确定HRR与各相关因素的一致性。结果：共纳入3926名患者进行研究，其中HRR≤4.97组934名，4.97 |
| 英文摘要: |
| 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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