Correlation between hemoglobin/red blood cell distribution width ratio and the prognosis in the patients with pulmonary embolism
Objective To explore the correlation between the hemoglobin/red blood cell distribution width ratio(HRR)and the mortality of patients with pulmonary embolism,as well as its value for the prognosis of these patients.Methods This retrospective study was conducted in the patients diagnosed with pulmonary embolism from the MIMIC-Ⅳ database(v2.2).The primary outcome assessed in this study was in-hospital mortality,while secondary outcomes included the mortality at 7 days,30 days post-ICU discharge.Logistic regression and restricted cubic spline(RCS)were adopted to explore the correlation between HRR and the mortality in pulmonary embolism patients;the prognostic value of HRR for patients with pulmonary embolism was analyzed by the receiver operating characteristic(ROC)curve;the robustness of the study results was evaluated by subgroup analysis and the interaction analyzed by the likelihood ratio test.By collecting the clinical data of the patients with pulmonary embolism admitted to Department of Peripheral Vascular Disease and ICU in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1,2021 to December 31,2023,the prognostic correlation between pulmonary embolism and HRR was further verified.Results In the study,a total of 2 282 patients were enrolled and stratified into Q1(＜0.81),Q2(0.81-0.99)and Q3(＞0.99)groups based on the tertiles of HRR.The Logistic regression model revealed a negative correlation between HRR and in-hospital mortality in the adjusted model 3(OR=0.202,95％CI 0.063-0.654).The RCS analysis further confirmed a linear correlation between HRR and in-hospital mortality.The receiver operating characteristic(ROC)curve analysis showed the area under curve(AUC)of HRR for predicting in-hospital mortality was 0.642 4(95％CI 0.586 3-0.698 5),indicating a significant predictive advantage of HRR.In subgroup analyses,the correlation of HRR with in-hospital mortality in the patients with pulmonary embolism was stable(P＜0.05),except for the Marriage-Other group(P=0.068),Race-Black group(P=0.497)and continuous renal replacement therapy(CRRT)-Yes group(P=0.522).There was no significant interaction between HRR and the other groups(interaction P=0.152-0.821),except for the lower extremity deep vein thrombosis group(interaction P=0.019)and diabetes group(interaction P=0.019).The ROC curve was used to verify the clinical data of domestic patients with pulmonary embolism,the AUC was 0.851 5(95％CI 0.745 5-0.957 5).Conclusions HRR demonstrated a significant linear negative correlation with the mortality in the patients with pulmonary embolism,and HRR was a relatively independent predictor.
Pulmonary embolismHemoglobin/red blood cell distribution width ratioCorrelationRestricted cubic splineLogistic regressionInteraction
万方数据
维普
