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Xie Z, Lv X, Dai S, Ma Y, Wang J. Nomogram Prediction of Prognosis After Surgical Operation for Cerebral Hemorrhage. World Neurosurg 2025; 197:123936. [PMID: 40139496 DOI: 10.1016/j.wneu.2025.123936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 03/15/2025] [Accepted: 03/17/2025] [Indexed: 03/29/2025]
Abstract
OBJECTIVE This study aimed to investigate the risk factors for intensive care unit (ICU) mortality in patients with intracerebral hemorrhage after surgery and to construct a clinical nomogram. METHODS The data in this retrospetive analysis were acquired from the Medical Information Mart for Intensive Care IV database, and the study controls were randomly divided into training and validation subsets in a ratio of 7:3. The primary clinical endpoint was all-cause ICU mortality. The prediction model was developed and a nomogram was generated based on findings of the logistic regression and least absolute shrinkage and selection operator regression analyses. Receiver operating characteristic curve was employed to assess model performance, and decision curve analysis was used to assess the clinical utility of the nomogram. RESULTS This retrospective study comprised 859 participants, of whom 757 were survivors and 102 were nonsurvivors. The results showed that red cell distribution width (P = 0.014), Glucose (P < 0.001), mechanical ventilation ≥48 hours (P < 0.001), acute respiratory failure (P = 0.019), and Sequential Organ Failure Assessment (P = 0.017) were independent risk factors for death after intracerebral hemorrhage surgery. The results of the nomogram showed that blood glucose and red cell distribution width had the greatest impact on prognosis. The nomogram demonstrated strong discriminating for all-cause mortality in the ICU and showed a positive net benefit across a broad spectrum of threshold probabilities. CONCLUSIONS For patients with severe cerebral hemorrhage after craniotomy, we developed a distinctive nomogram model to forecast all-cause mortality in the critical care unit. It can simply and intuitively display the risk of poor prognosis for patients, providing clinicians with an important treatment tool for individualized treatment and outcome forecasting.
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Affiliation(s)
- Zhijie Xie
- Department of Neurosurgery, The First People's Hospital of Linping District, HangZhou City, China.
| | - Xuan Lv
- Department of Neurosurgery, The First People's Hospital of Linping District, HangZhou City, China
| | - Shanshan Dai
- Department of Neurosurgery, The First People's Hospital of Linping District, HangZhou City, China
| | - Yijun Ma
- Department of Neurosurgery, The First People's Hospital of Linping District, HangZhou City, China
| | - Jun Wang
- Department of Neurosurgery, The First People's Hospital of Linping District, HangZhou City, China
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Liang X, Xing D, Zhuang Z, Feng H, Li S, Fang X, Wang F, Qiu L, Chen XL. Prognostic Value of Red Blood Cell Width Distribution-to-Platelet Ratio in Patients with Snakebite-Associated Multiple Organ Dysfunction Syndrome: A Retrospective Observational Study. J Inflamm Res 2025; 18:5281-5291. [PMID: 40264593 PMCID: PMC12013637 DOI: 10.2147/jir.s507234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Accepted: 03/29/2025] [Indexed: 04/24/2025] Open
Abstract
Background Snakebite-induced organ dysfunction emerging as the primary determinant of morbidity and mortality. This study aims to explore the prognostic value of red blood cell distribution width (RDW) to platelet ratio (RPR) on multi-organ dysfunction (MODS) in patients with snake bites. Methods A retrospective study included 637 patients with snakebite between 2015 and 2020 from two hospitals in Anhui province, China. Data were collected at two time points: on the 1st-day and the 5th-day after treatment. All patients were divided into two groups according to the presence or absence of MODS. T-tests, chi-square tests, and univariate and multivariate logistical analyses were used to identify the prognostic factors for the development of MODS. Results 56 (8.8%) patients developed MODS following snakebite. Logistics analyses indicated that from being bitten at the hospital, the 1st-day of red blood cell distribution width-to-platelet ratio (RPR) and creatinine (CR) levels, and the 5th-day of aspartate aminotransferase (AST) were significantly associated with the development of MODS. The sensitivity and the specificity of the 1st-day RPR were calculated by the received operating characteristic curve (AUC=0.720, 95% CI, 0.642-0.798). The 1st day RPR=0.110 and the 5th day RPR=0.085. Conclusion The study found that the RPR is an independent risk factor for predicting multi-organ dysfunction in patients with snake bites. The 1st-day RPR >0.110 is prone to be a new independent predictive factor for the development of MODS after snakebite.
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Affiliation(s)
- Xun Liang
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230032, People’s Republic of China
| | - Danlei Xing
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Zhiwei Zhuang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Hui Feng
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230032, People’s Republic of China
| | - Shiji Li
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Xiao Fang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Fei Wang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Le Qiu
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Xu-Lin Chen
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
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Lyu Y, Wang H, Zhong Z, Wang B. Predictive Value of Red Blood Cell Distribution Width-to-Platelet Ratio for Severity in Pyogenic Liver Abscess: A Retrospective Observational Study. Surg Infect (Larchmt) 2025; 26:33-38. [PMID: 39436861 DOI: 10.1089/sur.2024.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024] Open
Abstract
Background: The ratio of red blood cell distribution width (RDW) to platelet ratio (RPR) may have prognostic value in several inflammation-related diseases. However, few studies have been conducted on the value of RPR for predicting the severity of pyogenic liver abscess (PLA). Methods: Patients receiving the diagnosis of PLA from February 2013 to December 2022 were enrolled in this retrospective study. We collected data related to baseline characteristics and laboratory results within the first 24 hours the of admission. The receiver operating characteristic curve and the area under the curve (AUC) were used to evaluate the predictive ability of different indicators for severity in PLA. Results: A total of 278 patients were enrolled. For the prediction of sepsis in PLA, RPR had the highest AUC (0.83; 95% confidence interval [CI], 0.78-0.89) with a sensitivity of 0.78 and specificity of 0.82. For the prediction of septic shock, RPR also had the highest AUC (0.74; 95% CI, 0.60-0.88) with a sensitivity of 0.67 and specificity of 0.79. The best cutoff value for RPR to predict sepsis was 0.08 and to predict septic shock was 0.11. Conclusions: An increase in RPR level serves as a useful indicator with a predictive capacity for severity in PLA.
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Affiliation(s)
- Yunxiao Lyu
- Department of Hepatobiliary Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, P.R. China
| | - Hao Wang
- Department of Hepatobiliary Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, P.R. China
| | - Zhuojun Zhong
- Department of Hepatobiliary Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, P.R. China
| | - Bin Wang
- Department of Hepatobiliary Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, P.R. China
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Zheng MH, Lonardo A. Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease. World J Gastroenterol 2025; 31:100393. [PMID: 39839903 PMCID: PMC11684166 DOI: 10.3748/wjg.v31.i3.100393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 11/12/2024] [Accepted: 12/02/2024] [Indexed: 12/20/2024] Open
Abstract
Prognostication of compensated advanced chronic liver disease (cACLD) is of paramount importance for the physician-and-patient communication and for rational clinical decisions. The paper published by Dallio et al reports on red cell distribution width (RDW)/platelet ratio (RPR) as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease (MASLD)-related cACLD. Differently from other biomarkers and algorithms, RPR is inexpensive and widely available, based on parameters which are included in a complete blood count. RPR is computed on the grounds of two different items, one of which, RDW, mirrors the host's response to a variety of disease stimuli and is non-specific. The second parameter involved in RPR, platelet count, is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for decades. Cardiovascular disease is the primary cause of mortality among MASLD subjects, followed by extra-hepatic cancers and liver-related mortality. Therefore, MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic cancers. Adequately sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.
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Affiliation(s)
- Ming-Hua Zheng
- Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Amedeo Lonardo
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria of Modena (2023), Modena 41126, Italy
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Lu R, Wu C. Association between platelet-to-red cell distribution width ratio and all-cause mortality in critically ill patients with non-traumatic cerebral hemorrhage: a retrospective cohort study. Front Neurol 2024; 15:1456884. [PMID: 39669106 PMCID: PMC11634754 DOI: 10.3389/fneur.2024.1456884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 11/13/2024] [Indexed: 12/14/2024] Open
Abstract
Background The purpose of this study was to investigate the relationship between platelet-to-red cell distribution width ratio (PRR) and all-cause mortality in critically ill patients with non-traumatic cerebral hemorrhage (NCH). Methods The Medical Information Mart for Intensive Care (MIMIC-IV) database was used to identify patients with NCH who needed to be admitted to intensive care unit (ICU). The outcomes of the study included both ICU and in-hospital mortality. Restricted cubic splines and Cox proportional hazards regression analysis were used to clarify the relationship between PRR and clinical outcomes in critically ill patients with NCH. Results A total of 3,094 patients (54.0% male) were included in the study, with in-hospital mortality and ICU mortality rates of 16.5 and 11.8%, respectively. A substantial correlation was found by multivariate Cox proportional hazards analysis between increased PRR and a lower risk of in-hospital and ICU mortality. Following adjustment for confounding factors, patients with elevated PRR exhibited a significantly decreased risk of in-hospital death (HR, 0.98; 95% CI, 0.96-0.99; p = 0.006) and ICU death (HR, 0.98; 95% CI, 0.96-0.99; p = 0.027). As PRR increased, restrictive cubic splines showed a progressive decrease in the probability of all-cause mortality. Stratified analyses indicated a consistent association between PRR and both in-hospital and ICU mortality. Conclusion Among critically ill patients with NCH, lower PRR was substantially correlated with the increased probability of all-cause mortality in both the ICU and hospital. According to this research, PRR might be a valuable indicator for identifying NCH patients at risk of all-cause mortality.
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Affiliation(s)
- Rongrong Lu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changcai Wu
- Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Si Y, Sun B, Huang Y, Xiao K. Predictive Value of Red Cell Distribution Width-to-Platelet Ratio Combined with Procalcitonin in 28-day Mortality for Patients with Sepsis. Crit Care Res Pract 2024; 2024:9964992. [PMID: 39161851 PMCID: PMC11333126 DOI: 10.1155/2024/9964992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/01/2024] [Accepted: 08/03/2024] [Indexed: 08/21/2024] Open
Abstract
Objectives The objective of this study was to investigate the predictive value of erythrocyte distribution width-to-platelet ratio (RPR) combined with procalcitonin (PCT) on 28-day mortality in patients with sepsis. Methods A total of 193 patients with sepsis admitted to the Affiliated Hospital of Southwest Medical University from January 2013 to January 2018 were selected as the study objects. Univariate and multivariate analyses were used to understand the indicators related to the 28-day prognosis of patients, and the ROC curve was further drawn. The Kaplan-Meier curve was used to evaluate the prognosis of patients. Results A total of 193 patients were enrolled and divided into the survivor group (=156) and nonsurvivor group (=37) according to the prognosis within 28 days. The median age was 62.5 years, and 64.7% were males. Multivariate analysis showed that PCT and RPR were independent risk factors for 28-day prognosis in sepsis patients. The area under the ROC curve of PCT and RPR were 0.894 and 0.861, respectively, and the cutoff values were 27.04 and 0.12, respectively. Survival curve analysis showed that PCT and RPR were associated with the 28-day prognosis of patients, and the combination of PCT and RPR had a better predictive effect. Conclusions PCT and RPR are independent predictors of sepsis prognosis. The combined application of PCT and RPR (PCT-RPR) can further improve the predictive performance and provide a reference for the clinical diagnosis, treatment, and prognosis evaluation of sepsis patients.
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Affiliation(s)
- Ying Si
- Department of Infectious DiseasesDepartment of Tuberculosis, Infection, and Immunity LaboratoryThe Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Bo Sun
- Department of UltrasoundThe Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yongmao Huang
- Department of Infectious DiseasesDepartment of Tuberculosis, Infection, and Immunity LaboratoryThe Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ke Xiao
- Department of Infectious DiseasesDepartment of Tuberculosis, Infection, and Immunity LaboratoryThe Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Liang H, Liu P, Guo L, Feng J, Yin C, Zhao D, Chen L. Predictive value of admission red cell distribution width-to-platelet ratio for 30-day death in patients with spontaneous intracerebral hemorrhage: an analysis of the MIMIC database. Front Neurol 2023; 14:1221335. [PMID: 37920838 PMCID: PMC10618669 DOI: 10.3389/fneur.2023.1221335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Aim Prognostic assessment plays an important role in the effective management of patients with spontaneous intracerebral hemorrhage (ICH). The study aimed to investigate whether elevated red cell distribution width-to-platelet ratio (RPR) at admission was related to 30-day death in patients with spontaneous intracerebral hemorrhage (ICH). Methods This retrospective cohort study included 2,823 adult patients with ICH from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) III and IV databases between 2001 and 2019. The Cox proportional hazard model was utilized to evaluate the relationship between RPR levels and 30-day death risk. The area under receiver-operating characteristic curve (AUC) was used to assess the predictive ability of RPR for 30-day death in patients with ICH. Results At the end of the 30-day follow-up, 799 (28.30%) patients died, and the median RPR level was 0.066 (0.053, 0.087). After adjusting for confounders, the tertile 3 of RPR levels [hazard ratio (HR) = 1.37, 95% confidence interval (CI): 1.15-1.64] were associated with a higher risk of 30-day death in patients with ICH compared with tertile 1. In the stratified analyses, elevated RPR levels were found to be associated with an increased risk of 30-day death in patients aged <65 years (HR = 1.77, 95%CI: 1.29-2.43), aged ≥65 years (HR = 1.30, 95%CI: 1.05-1.61), with Glasgow Coma Score (GCS) <14 (HR = 1.65, 95%CI: 1.27-2.14), with Charlson comorbidity index (CCI) ≥4 (HR = 1.45, 95%CI: 1.17-1.80), with (HR = 1.66, 95%CI: 1.13-2.43) or without sepsis (HR = 1.32, 95%CI: 1.08-1.61), and female patients (HR = 1.75, 95%CI: 1.35-2.26) but not in male patients (P = 0.139) and patients with GCS ≥14 (P = 0.058) or CCI <4 (P = 0.188). The AUC for RPR to predict 30-day death in patients with ICH was 0.795 (95%CI: 0.763-0.828) in the testing set, indicating a good predictive ability. Conclusion Elevated RPR levels were correlated with an increased risk of 30-day death in patients with ICH, and RPP levels showed good predictive ability for 30-day death.
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Affiliation(s)
- Hanbai Liang
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Chen S, Shi Y, Hu B, Huang J. A Prediction Model for In-Hospital Mortality of Acute Exacerbations of Chronic Obstructive Pulmonary Disease Patients Based on Red Cell Distribution Width-to-Platelet Ratio. Int J Chron Obstruct Pulmon Dis 2023; 18:2079-2091. [PMID: 37750166 PMCID: PMC10518148 DOI: 10.2147/copd.s418162] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 09/27/2023] Open
Abstract
Purpose To explore the association between red cell distribution width (RDW)-to-platelet ratio (RPR) and in-hospital mortality of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients and establish a prediction model based on RPR and other predictors. Material and Methods This cohort study included 1922 AECOPD patients aged ≥18 years in the Medical Information Mart for Intensive Care (MIMIC)-III and MIMIC-IV as well as 1738 AECOPD patients from eICU Collaborative Research Database (eICU-CRD). Possible confounding factors were screened out by univariate logistic regression, and multivariable logistic regression was applied to evaluate the association between RPR and in-hospital mortality of AECOPD patients. The area under the curve (AUC), calibration curve and decision curve analysis (DCA) curve were plotted to evaluate the predictive value of the model. The median follow-up time was 3.14 (1.87, 6.25) day. Results At the end of follow-up, there were 1660 patients survived and 262 subjects died. After adjusting for confounders, we found that Log (RPR×1000) was linked with elevated risk of in-hospital mortality of AECOPD patients [odds ratio (OR)=1.36, 95% confidence interval (CI): 1.01-1.84]. The prediction model was constructed using predictors including Log (RPR×1000), age, malignant cancer, atrial fibrillation, ventilation, renal failure, diastolic blood pressure (DBP), temperature, Glasgow Coma Scale (GCS) score, white blood cell (WBC), creatinine, blood urea nitrogen (BUN), hemoglobin, infectious diseases and anion gap. The AUC of the prediction model was 0.785 (95% CI: 0.751-0.820) in the training set, 0.721 (95% CI: 0.662-0.780) in the testing set, and 0.795 (95% CI: 0.762-0.827) in the validation set. Conclusion RPR was associated with the in-hospital mortality of AECOPD patients. The prediction model for the in-hospital mortality of AECOPD patients based on RPR and other predictors presented good predictive performance, which might help the clinicians to quickly identify AECOPD patients at high risk of in-hospital mortality.
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Affiliation(s)
- Shi Chen
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan City, Hubei, 430000, People’s Republic of China
| | - Yi Shi
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan City, Hubei, 430000, People’s Republic of China
| | - Bingzhu Hu
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan City, Hubei, 430000, People’s Republic of China
| | - Jie Huang
- Department of Respiratory Medicine, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, 200031, People’s Republic of China
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Xu N, Peng C. Association between red cell distribution width-to-platelet ratio and short-term and long-term mortality risk in patients with acute ischemic stroke. BMC Neurol 2023; 23:191. [PMID: 37189031 DOI: 10.1186/s12883-023-03219-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The objective of this study was to evaluate the association between red cell distribution width/platelet ratio (RPR) and 30-day and 1-year mortality in acute ischemic stroke (AIS). METHODS Data for the retrospective cohort study were collected from the Medical Information Mart for Intensive Care (MIMIC) III database. RPR was divided into two groups: RPR ≤ 0.11 and RPR > 0.11. The study outcomes were 30-day mortality and 1-year mortality from AIS. Cox proportional hazard models were utilized to assess the association between RPR and mortality. Subgroup analyses were applied based on age, tissue-type plasminogen activator (IV-tPA), endovascular treatment, and myocardial infarction. RESULTS A total of 1,358 patients were included in the study. Short- and long-term mortality occurred in 375 (27.61%) and 560 (41.24%) AIS patients, respectively. A high RPR was significantly associated with increased 30-day [hazard ratio (HR): 1.45, 95% confidence interval (CI): 1.10 to 1.92, P = 0.009] and 1-year mortality (HR: 1.54, 95%CI: 1.23 to 1.93, P < 0.001) in AIS patients. Meanwhile, RPR was found to be significantly related to 30-day mortality in AIS patients aged < 65 years (HR: 2.19, 95% CI: 1.17 to 4.10, P = 0.014), without IV-tPA use (HR: 1.42, 95% CI: 1.05 to 1.90, P = 0.021), without using endovascular treatment (HR: 1.45, 95% CI: 1.08 to 1.94, P = 0.012), and without myocardial infarction (HR: 1.54, 95% CI: 1.13 to 2.10, P = 0.006). Additionally, RPR was associated with 1-year mortality in AIS patients aged < 65 years (HR: 2.54, 95% CI: 1.56 to 4.14, P < 0.001), aged ≥ 65 years (HR: 1.38, 95% CI: 1.06 to 1.19, P = 0.015), with (HR: 1.46, 95% CI: 1.15 to 1.85, P = 0.002) and without using IV-tPA (HR: 2.30, 95% CI: 1.03 to 5.11, P = 0.041), without using endovascular treatment (HR: 1.56, 95% CI: 1.23 to 1.96, P < 0.001), and without myocardial infarction (HR: 1.68, 95% CI: 1.31 to 2.15, P < 0.001). CONCLUSION Elevated RPR is associated with a high risk of short-term and long-term mortality in AIS.
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Affiliation(s)
- Nan Xu
- Department of Neurology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, People's Republic of China
| | - Cao Peng
- Department of Emergency, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, 430022, People's Republic of China.
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Yao H, Lian L, Zheng R, Chen C. Red blood cell distribution width/platelet ratio on admission as a predictor for in-hospital mortality in patients with acute myocardial infarction: a retrospective analysis from MIMIC-IV Database. BMC Anesthesiol 2023; 23:113. [PMID: 37016294 PMCID: PMC10071654 DOI: 10.1186/s12871-023-02071-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator. It integrates the risk prediction of RDW and platelet, which is associated with adverse outcomes. However, the predictive power of RPR in mortality for patients with acute myocardial infarction (AMI) remains uncertain. Thus, we aimed to explore the association between RPR and 180-day in-hospital mortality in patients with AMI. METHODS Data on patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into two groups according to the optimal RPR cut-off value. The survival curve between high and low RPR groups was plotted via the Kaplan-Meier (KM) method. Univariate and multivariate Cox regression analyses were performed to determine the association between RPR on admission and 180-day in-hospital mortality. RESULTS A total of 1266 patients were enrolled, of which 83 (6.8%) died within 180 days during the hospitalization. Compared with the survivor group, the non-survivor group had higher RPR on admission (0.11 ± 0.07 vs. 0.08 ± 0.06, P < 0.001). The KM curve indicated that the survival probability of low RPR group was higher than that of high RPR group. Multivariate Cox regression analysis demonstrated that higher RPR on admission was an independent and effective predictor of 180-day mortality in patients with AMI (hazard ratio [HR]: 2.677, 95% confidence interval [CI]: 1.159-6.188, P = 0.021). CONCLUSION Higher RPR was associated with higher in-hospital 180-day mortality in patients with AMI.
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Affiliation(s)
- Hongxia Yao
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liyou Lian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rujie Zheng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Chen
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Sun R, Huang F, Wu W, Yin G, Ding Q, Gu Z, Fan C, Song C, Liang M, Liu X, Bi X. Association of neutrophil to lymphocyte ratio and D-dimer with functional outcome in patients with cerebral venous sinus thrombosis. BMC Neurol 2023; 23:30. [PMID: 36658518 PMCID: PMC9850605 DOI: 10.1186/s12883-022-03030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Investigations on the risk factors for the prognosis of cerebral venous sinus thrombosis (CVST) are limited. This study aimed to explore whether specific inflammatory factors and coagulation indictors are associated with functional outcome in patients treated for CVST. METHODS This retrospective study included 137 patients admitted to our hospital between January 2010 and October 2021. The functional outcome was assessed with the modified Rankin Scale (mRS) score at discharge. Patients were divided into two groups, 102 patients with favorable outcomes (mRS 0-1) and 35 patients with poor outcomes (mRS 2-6). The clinical indexes were compared between two groups. Multivariable logistic regression was performed to identify the independent influencing factors for poor outcomes of CVST patients. The prognostic indicators were analyzed using the receiver operating characteristic (ROC) curve. RESULTS Compared with the favorable outcome group, the incidence of impaired consciousness and brain lesion, the levels of D-dimer, RDW, neutrophil count, neutrophil to lymphocyte ratio (NLR) and red blood cell distribution width to platelet ratio (%) on admission were significantly higher in the poor outcome group, while the level of lymphocyte count was significantly lower. After multivariable logistic regression analysis, baseline D-dimer level (odds ratio (OR), 1.180; 95% confidence interval (CI), 1.019-1.366, P = 0.027) and NLR (OR, 1.903; 95%CI, 1.232-2.938, P = 0.004) were significantly associated with unfavorable outcome at discharge. The ROC curve analysis showed that the areas under the curve of D-dimer, NLR and their combined detection for predicting worse outcome were 0.719, 0.707 and 0.786, respectively. CONCLUSIONS Elevated D-dimer level and NLR on admission were associated with an increased risk of poor functional outcome in patients with CVST.
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Affiliation(s)
- Rui Sun
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Feihong Huang
- Department of Neurology, Guilin People’s Hospital, Guilin, 541000 China
| | - Wen Wu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Ge Yin
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Qichao Ding
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Zhengsheng Gu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Cunxiu Fan
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Chenrui Song
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Meng Liang
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Xiaobei Liu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Xiaoying Bi
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
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Zhou Y, Zhong L, Chen W, Liang F, Liao Y, Zhong Y. Enhanced red blood cell distribution width to platelet ratio is a predictor of mortality in patients with sepsis: a propensity score matching analysis based on the MIMIC-IV database. BMJ Open 2022; 12:e062245. [PMID: 36153009 PMCID: PMC9511593 DOI: 10.1136/bmjopen-2022-062245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the association between dynamic changes in red blood cell distribution width to platelet count ratio (RPR) during hospitalisation and short-term mortality in patients with sepsis. DESIGN A retrospective cohort study using propensity score matching. SETTING Intensive care units (ICUs) of Beth Israel Deaconess Medical Center. PARTICIPANTS A total of 8731 adult patients with sepsis were included in the study. The patients were identified from the ICU of the Medical Information Mart for Intensive Care database. The observed group included patients who experienced an increase in RPR of more than 30% during the first week of ICU admission, whereas the control group included the rest. MAIN OUTCOME AND MEASURE Using propensity score matching, a matched control group was created. The primary outcome was 28-day mortality, and the length of hospital stay and in-hospital mortality were the secondary outcomes. RESULTS The difference was evident in 28-day mortality between the two groups (85.8% vs 74.5%, p<0.001, Kaplan-Meier analysis, and HR=1.896, 95% CI=1.659 to 2.168, p<0.001, Cox regression). In the secondary outcomes, there was a significant difference in in-hospital mortality (p<0.001). In addition, the study discovered that the observed groups had a significantly longer hospital stay (p<0.001). Meanwhile, the results of subgroup analyses were consistent with those of the primary analyses. CONCLUSIONS In patients with sepsis, a significantly increased RPR is positively associated with the short-term death rate. Continuous RPR monitoring could be a valuable measure for predicting short-term mortality in patients with sepsis.
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Affiliation(s)
- Yuanjun Zhou
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Liping Zhong
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Weiming Chen
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Fei Liang
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Yilin Liao
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Yuting Zhong
- Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China
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Tong L, Liu YQ, Shen JH, B O M, Zhou Q, Duan XJ, Guo YF, Zhang XQ. Relationship between the red cell distribution width-to-platelet ratio and in-hospital mortality among critically ill patients with acute myocardial infarction: a retrospective analysis of the MIMIC-IV database. BMJ Open 2022; 12:e062384. [PMID: 36691156 PMCID: PMC9442484 DOI: 10.1136/bmjopen-2022-062384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES We aimed to investigate the association between red cell distribution width-to-platelet ratio (RPR), and in-hospital mortality in critically ill patients with acute myocardial infarction (AMI). DESIGN A retrospective cohort study. SETTING Data were collected from the Medical Information Mart for Intensive Care database (MIMIC-IV) consisting of critically ill participants between 2008 and 2019 at the Beth Israel Deaconess Medical Centre in Boston. PARTICIPANTS A total of 5067 patients with AMI were enrolled from the MIMIC-IV database. PRIMARY AND SECONDARY OUTCOME In-hospital mortality. RESULTS A total of 4034 patients survived, while 1033 died. In a multiple regression analysis adjusted for age, weight and ethnicity, RPR also showed a positive correlation with in-hospital mortality (HR 1.91, 95% CI 1.42 to 2.56, p<0.0001). Moreover, after adjusting for additional confounding factors, obvious changes were observed (HR 1.63, 95% CI 1.03 to 2.57, p=0.0357). In model 2, the high ratio quartile remained positively associated with hospital mortality compared with the low ratio quartile (HR 1.20, 95% CI 1.01 to 1. 43), with a p-value trend of 0.0177. Subgroup analyses showed no significant effect modifications on the association between RPR and in-hospital mortality in the different AMI groups (p>0.05). CONCLUSION RPR is an independent predictor of in-hospital mortality in critically ill patients with AMI.
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Affiliation(s)
- Li Tong
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
| | - Yan-Qiong Liu
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
| | - Jin Hua Shen
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
| | - Min B O
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
| | - Quan Zhou
- Department of Science and Education, First People's Hospital of Changde City, Changde, Hunan, China
| | - Xiang-Jie Duan
- Department of Infectious Diseases, First People's Hospital of Changde City, Changde, Hunan, China
| | - Ya Fen Guo
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
| | - Xue Qing Zhang
- Department of Nursing, First People's Hospital of Changde City, Changde, Hunan, China
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Deng X, Li T, Mo L, Wang F, Ji J, He X, Mohamud BH, Pradhan S, Cheng J. Machine learning model for the prediction of prostate cancer in patients with low prostate-specific antigen levels: A multicenter retrospective analysis. Front Oncol 2022; 12:985940. [PMID: 36059701 PMCID: PMC9433549 DOI: 10.3389/fonc.2022.985940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this study was to develop a predictive model to improve the accuracy of prostate cancer (PCa) detection in patients with prostate specific antigen (PSA) levels ≤20 ng/mL at the initial puncture biopsy. Methods A total of 146 patients (46 with Pca, 31.5%) with PSA ≤20 ng/mL who had undergone transrectal ultrasound-guided 12+X prostate puncture biopsy with clear pathological results at the First Affiliated Hospital of Guangxi Medical University (November 2015 to December 2021) were retrospectively evaluated. The validation group was 116 patients drawn from Changhai Hospital(52 with Pca, 44.8%). Age, body mass index (BMI), serum PSA, PSA-derived indices, several peripheral blood biomarkers, and ultrasound findings were considered as predictive factors and were analyzed by logistic regression. Significant predictors (P < 0.05) were included in five machine learning algorithm models. The performance of the models was evaluated by receiver operating characteristic curves. Decision curve analysis (DCA) was performed to estimate the clinical utility of the models. Ten-fold cross-validation was applied in the training process. Results Prostate-specific antigen density, alanine transaminase-to-aspartate transaminase ratio, BMI, and urine red blood cell levels were identified as independent predictors for the differential diagnosis of PCa according to multivariate logistic regression analysis. The RandomForest model exhibited the best predictive performance and had the highest net benefit when compared with the other algorithms, with an area under the curve of 0.871. In addition, DCA had the highest net benefit across the whole range of cut-off points examined. Conclusion The RandomForest-based model generated showed good prediction ability for the risk of PCa. Thus, this model could help urologists in the treatment decision-making process.
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Affiliation(s)
- Xiaobin Deng
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Tianyu Li
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Linjian Mo
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Fubo Wang
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Jin Ji
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xing He
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Bashir Hussein Mohamud
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Swadhin Pradhan
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiwen Cheng
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- *Correspondence: Jiwen Cheng,
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