Objective To explore the role of the red cell distribution width to albumin ratio(RAR)in assessing the prognosis of patients with severe acute pancreatitis(SAP).Methods A retrospective analysis was conducted on 638 SAP patients using the American MIMIC-Ⅳ database. Patients were divided into the survival and the death groups based on the prognosis within 180 days. The non-linear relationship between RAR and the risk of death was analyzed using restricted cubic splines (RCS). Patients were divided into three groups according to the tertiles of RAR:the low RAR group (<4.22),the medium RAR group (4.22～5.39),and the high RAR group (>5.39). The impact of RAR on survival rate was assessed using Kaplan-Meier survival curves and Log-rank tests. A Cox regression risk model was established,and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive ability of RAR. Results The death group had significantly higher RAR,age,SOFA score,APACHE Ⅲ score,white blood cell count,and more frequent use of norepinephrine,mechanical ventilation,and renal replacement therapy than the survival group,while albumin,red blood cells,and platelet counts were lower than the survival group(P<0.05).RCS analysis showed a non-linear relationship between RAR and the risk of all-cause mortality within 180 days.Kaplan-Meier survival curves indicated that the high RAR group had significantly lower cumulative survival rates at 180 and 360 days compared to the medium and low RAR groups,with statistically significant differences(P<0.05).The Cox regression model confirmed that a high RAR level(>5.39)was an independent risk factor for poor prognosis at 180 and 360 days.ROC curve analysis suggested that the predictive performance of RAR combined with the SOFA score was superior to that of a single factor.Conclusion Elevated RAR levels(>5.39)at admission are an independent predictor of poor mid-to-long term prognosis in SAP patients,and RAR combined with the SOFA score can significantly improve the accuracy of prognosis assessment,which is of great significance for clinical nursing management.
Red cell distribution width to albumin ratioSevere acute pancreatitisMIMIC databasePrognostic assessment
万方数据
维普
