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. 2024 Mar 6:12:1352195.
doi: 10.3389/fped.2024.1352195. eCollection 2024.

Association between red cell distribution width-to-albumin ratio and prognostic outcomes in pediatric intensive care unit patients: a retrospective cohort study

Rui Jing  1 , Baolong Yu  1 , Chenchen Xu  1 , Ying Zhao  1 , Hongmei Cao  1 , Wenhui He  2 , Haili Wang  1
Affiliations

Association between red cell distribution width-to-albumin ratio and prognostic outcomes in pediatric intensive care unit patients: a retrospective cohort study

Rui Jing et al. Front Pediatr. .

Abstract

Objective: This study aimed to assess the association between Red Cell Distribution Width-to-Albumin Ratio (RAR) and the clinical outcomes in Pediatric Intensive Care Unit (PICU) patients.

Design: This is a retrospective cohort study.

Methods: We conducted a retrospective cohort study based on the Pediatric Intensive Care database. The primary outcome was the 28-day mortality rate. Secondary outcomes included the 90-day mortality rate, in-hospital mortality rate, and length of hospital stay. We explored the relationship between RAR and the prognosis of patients in the PICU using multivariate regression and subgroup analysis.

Results: A total of 7,075 participants were included in this study. The mean age of the participants was 3.4 ± 3.8 years. Kaplan-Meier survival curves demonstrated that patients with a higher RAR had a higher mortality rate. After adjusting for potential confounding factors, we found that for each unit increase in RAR, the 28-day mortality rate increased by 6% (HR = 1.06, 95% CI: 1.01-1.11, P = 0.015). The high-RAR group (RAR ≥ 4.0) had a significantly increased 28-day mortality rate compared to the low-RAR group (RAR ≤ 3.36) (HR = 1.7, 95% CI: 1.23-2.37, P < 0.001). Similar results were observed for the 90-day and in-hospital mortality rate. No significant interactions were observed in the subgroup analysis.

Conclusion: Our study suggests a significant association between RAR and adverse outcomes in PICU patients. A higher RAR is associated with higher 28-day, 90-day, and in-hospital mortality rates.

Keywords: 28-day mortality rate; albumin; critically ill pediatric patients; pediatric intensive care unit; red cell distribution width-to-Albumin ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study patient enrollment.
Figure 2
Figure 2
Kaplan–Meier curve of 28-day mortality for patients in PICU (A) Kaplan–Meier curve of 90-day mortality for patients in PICU (B).
Figure 3
Figure 3
Curve fitting of RAR and 28-day mortality in PICU patients. RAR, Red blood cell distribution width to albumin ratio.
Figure 4
Figure 4
Subgroup analysis of the association between RAR and 28-day mortality in PICU patients.
See this image and copyright information in PMC

References

    1. Burns JP, Sellers DE, Meyer EC, Lewis-Newby M, Truog RD. Epidemiology of death in the PICU at five U. S. Teaching Hospitals*. Crit Care Med. (2014) 42(9):2101–8. 10.1097/CCM.0000000000000498 - DOI - PMC - PubMed
    1. Macdougall IC, Cooper AC. Erythropoietin resistance: the role of inflammation and pro-inflammatory cytokines. Nephrol Dial Transplant. (2002) 17(Suppl 11):39–43. 10.1093/ndt/17.suppl_11.39 - DOI - PubMed
    1. Bateman RM, Sharpe MD, Singer M, Ellis CG. The effect of sepsis on the erythrocyte. Int J Mol Sci. (2017) 18(9):1932. 10.3390/0.3390/ijms18091932 - DOI - PMC - PubMed
    1. Go H, Ohto H, Nollet KE, Sato K, Ichikawa H, Kume Y, et al. Red cell distribution width as a predictor for bronchopulmonary dysplasia in premature infants. Sci Rep. (2021) 11(1):7221. 10.1038/s41598-021-86752-8 - DOI - PMC - PubMed
    1. Yu XS, Chen ZQ, Hu YF, Chen JX, Xu WW, Shu J, et al. Red blood cell distribution width is associated with mortality risk in patients with acute respiratory distress syndrome based on the Berlin definition: a propensity score matched cohort study. Heart Lung. (2020) 49(5):641–5. 10.1016/j.hrtlng.2020.04.008 - DOI - PubMed

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