■低氯血症和红细胞分布宽度(RDW)在充血性心力衰竭(CHF)病理生理学中起重要作用,与CHF的预后相关。然而,氯联合RDW对CHF患者的预后价值尚不清楚.
■我们回顾性分析了CHF的危重患者。该数据库来自重症监护医学信息集市IVv2.0(MIMIC-IV-v2.0)数据库。
■归根结底,5376例CHF危重患者纳入研究,2428例(45.2%)患者5年死亡率.受限三次样条模型显示RDW与5年死亡率呈正相关,而氯化物与5年死亡率呈U型相关。使用RDW和氯化物的中值将患者分为四组:高氯化物/低RDW,低氯化物/低RDW,高氯化物/高RDW,和低氯化物/高RDW。我们在Cox比例风险模型中观察了RDW联合氯化物的预后价值,在预测5年死亡率时,住院死亡率和1年死亡率。此外,我们发现慢性肾脏病(CKD)患者的5年死亡风险高于非CKD患者.
■我们发现氯化物联合RDW在CHF危重患者队列中优先考虑短期和长期死亡率高的患者方面具有转化潜力。有必要进行前瞻性多中心调查以验证我们的结果。
UNASSIGNED: Hypochloremia and red blood cell distribution width (RDW) play important roles in congestive heart failure (CHF) pathophysiology, and they were associated with the prognosis of CHF. However, the prognostic value of
chloride combined with RDW in patients with CHF remains unknown.
UNASSIGNED: We retrospectively analyzed critically ill patients with CHF. The database was derived from the Medical Information Mart for Intensive Care IV v2.0 (MIMIC-IV-v2.0) database.
UNASSIGNED: In the final analysis, 5376 critically ill patients with CHF were included, and 2428 patients (45.2 %) experienced 5-year mortality. The restricted cubic spline model revealed a positive correlation between RDW and 5-year mortality, whereas
chloride showed a U-shaped correlation with 5-year mortality. The median values of RDW and
chloride were used to classify patients into four groups: high
chloride/low RDW, low
chloride/low RDW, high
chloride/high RDW, and low
chloride/high RDW. We observed the prognostic value of RDW combined with
chloride in the Cox proportional hazard model, in predicting 5-year mortality, in-hospital mortality and 1-year mortality. Furthermore, we discovered that patients with chronic kidney disease (CKD) had a higher 5-year mortality risk than patients without CKD.
UNASSIGNED: We found the translational potential role of chloride combined with RDW in prioritizing patients at high risk for short- and long-term mortality in a cohort of critically ill patients with CHF. Prospective multicenter investigations are warranted to validate our results.