背景:低白蛋白水平和高红细胞分布宽度水平的脓毒症患者预后较差。红细胞分布宽度与白蛋白之比(RAR)最近作为一种创新的炎症生物标志物引起了人们的关注。我们旨在探讨RAR与脓毒症患者预后之间的关系。
方法:这项回顾性观察研究纳入了2020年1月至2022年12月在烟台玉皇顶医院重症监护病房(ICU)收治的402例符合脓毒症-3标准的患者。使用回归分析检查脓毒症患者的RAR与死亡率之间的关系,Kaplan-Meier分析,和接收器工作特性曲线。进行亚组和敏感性分析以评估结果的稳健性。
结果:RAR,当被视为连续变量时,是一个显著的住院死亡独立危险因素(校正比值比[OR]:1.383;95%置信区间[CI]:1.164-1.645;P<0.001).当将RAR视为分类变量时,四分位数2(Q2)医院死亡率的OR(95%CI),Q3、Q4与Q1相比分别为1.027(0.413-2.551),3.632(1.579-8.354),和4.175(1.625-10.729),分别,P<0.001。对于28天和90天的死亡率观察到类似的结果。
结论:RAR可能表明ICU脓毒症患者的临床预后,可能提供低成本,易于重复,以及这些患者的风险分类的可获取生物标志物。
BACKGROUND: Patients with sepsis with low albumin levels and high red blood cell distribution width levels have poor prognoses. Red blood cell distribution width to albumin ratio (RAR) has recently attracted attention as an innovative inflammation biomarker. We aimed to explore the association between RAR and the prognosis of patients with sepsis.
METHODS: This retrospective observational study included 402 patients meeting the sepsis-3 standards admitted to Yantai Yuhuangding Hospital\'s intensive care units (ICUs) between January 2020 and December 2022. The relationship between RAR and mortality in patients with sepsis was examined using regression analysis, Kaplan-Meier analyses, and a receiver operating characteristic curve. Subgroup and sensitivity analyses were conducted to assess the results\' robustness.
RESULTS: RAR, when considered as a continuous variable, was a significant independent in-hospital mortality risk factor (adjusted odds ratio [OR]: 1.383; 95% confidence interval [CI]: 1.164-1.645; P < 0.001). When considering RAR as a categorical variable, the ORs (95% CIs) of hospital mortality for quartile 2 (Q2), Q3, and Q4 compared with Q1 were 1.027 (0.413-2.551), 3.632 (1.579-8.354), and 4.175 (1.625-10.729), respectively, P < 0.001. Similar outcomes were observed for 28- and 90-day mortalities.
CONCLUSIONS: RAR may indicate clinical prognosis for patients with sepsis in the ICU, potentially providing a low-cost, easily repeatable, and accessible biomarker for risk categorization for these patients.