Predictive value of red blood cell distribution width in critically ill patients with atrial fibrillation: a retrospective cohort study.
Predictive value of red blood cell distribution width in critically ill patients with atrial fibrillation: a retrospective cohort study.
复制标题
红细胞分布宽度对危重房颤患者的预测价值：一项回顾性队列研究。
DOI：
10.21037/apm-20-1704
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发表时间：
2021-01
影响因子：
--
通讯作者：
Yanbo Zhao
中科院分区：
文献类型：
--
作者：
Tingting Tao;Min Wang;Zhida Shen;Hongfen Zeng;Xue Lu;Zetao Ma;Yanbo Zhao
背景
心房颤动（AF）是老年患者尤其是ICU患者发病和死亡的主要原因。以往的研究表明红细胞分布宽度（RDW）对预测房颤发作的影响。然而，RDW在危重房颤患者中的预后价值仍然很大程度上未知。因此，本研究的目的是探讨预测重症房颤患者院内和院外死亡率的潜在价值。
方法
从重症监护医学信息市场（MIMIC）III数据库中提取数据，入组了7，867例重症房颤患者。以多元Logistic回归分析为设计变量，评价RDW与住院死亡率之间的关系。在通过倾向评分匹配（PSM）算法平衡的危重患者中，比较低RDW组和高RDW组的短期和长期结局。
结果
对7，867例患者的分析显示RDW与住院死亡率之间存在线性关系。对于AF危重患者，RDW水平升高与院内死亡率增加相关，OR从2级（OR：1.75，95%CI：1.25 - 2.44）增加至5级（OR：3.89，95%CI：2.55 - 5.93），以1级（RDW ≤13）作为参考组。通过PSM算法选择了CareVue系统中有记录的3841例入组患者。1,054对入组患者的基线特征平衡良好。高RDW组生存率明显低于对照组（P<0.001）。
结论
高水平的RDW与AF危重患者的院内外死亡率增加相关。
BACKGROUND
Atrial fibrillation (AF) is a leading cause of morbidity and mortality among elderly patients especially for patients in ICU. Previous studies revealed the impact of red blood cell distribution width (RDW) on predicting onset of AF. However, the prognostic value of RDW in critically ill patients with AF remains largely unknown. Thus, this study aims to explore the potential value on predicting in- and out-of-hospital mortality in critically ill patients with AF.
METHODS
Data were extracted from the Medical Information Mart for Intensive Care (MIMIC) III database and 7,867 critically ill patients with AF were enrolled. The association between RDW and inhospital mortality was evaluated using the multiple logistic regression analysis as a design variable. Shortand long-term outcomes were compared between the low RDW and high RDW groups in critically ill patients balanced by the propensity score matching (PSM) algorithm.
RESULTS
Analysis of the 7,867 patients revealed a linear relationship between RDW and in-hospital mortality. For critically ill patients with AF, the elevated level of RDW was associated with increased inhospital mortality, with the OR increasing from level 2 (OR: 1.75, 95% CI: 1.25 to 2.44) to level 5 (OR: 3.89, 95% CI: 2.55 to 5.93) with level 1 (RDW ≤13) as the reference group. 3841 enrolled patients with records in the CareVue systems were selected by PSM algorithm. The baseline characters were well balanced in 1,054 pairs of enrolled patients. A significant lower survival rate was observed in the high RDW group (P<0.001).
CONCLUSIONS
High levels of RDW are associated with increased in- and out-of-hospital mortality in critically ill patients with AF.
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DOI：
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发表时间：
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