The red blood cell distribution width-to-albumin ratio (RAR) serves as an indicator of systemic inflammation and nutritional status. This study examines the relationship between RAR and depressive disorder in U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

We applied logistic regression to evaluate the link between RAR and depressive risk, with its corresponding odds ratios (OR) and 95 % confidence intervals (CI) calculated. Restricted cubic spline (RCS) was adopted to assess the potential linear association, while the receiver operating characteristic (ROC) curve was used to evaluate the ability of RAR to predict the depressive risk, with the result presented as an area under the curve (AUC).

After adjusting for relevant covariates, a positive association between RAR and clinically relevant depression persisted (OR = 1.33, 95 % CI: 1.18-1.51, P < 0.001). Participants in the highest RAR quartile exhibited a greater risk of clinically relevant depression than those in the lowest quartile (OR = 1.36, 95 % CI: 1.10-1.67, P = 0.005). A linear relationship between RAR and clinically relevant depression was identified (P for non-linear = 0.473), with RAR showing a strong predictive ability for depressive risk (AUC = 0.7467). Stratified analysis showed significant interactions among smoking (P = 0.045), marital status (P < 0.001), and RAR's effect on depression outcome.

Elevated RAR is independently linked to clinically relevant depression, indicating its potential as a novel biomarker for mental health risk assessment. Further longitudinal studies are necessary to establish causality and evaluate its clinical relevance.

Recent studies from various countries, including those in Africa, have highlighted the importance of region-specific data in assessing hematological health. However, no study has established hematological reference intervals (RIs) in Northern Sudan. We aimed to investigate the normal hematological values among apparently healthy adults in Northern Sudan.

A cross-sectional study was conducted in Northern Sudan. Standardized procedures measured participants' weight, height, and hematological parameters. The Mann-Whitney U test was used to compare the parameters between males and females. Mean, median, and RIs (2.5th-97.5th percentiles) were computed for the adults.

Two hundred fifty-three adults were enrolled (141 [55.7%] males and 112 [44.3%] females). The median (interquartile [IQR]) of the enrolled adults' age was 40.0 (29.7-50.0) years. The RIs for both genders, hemoglobin 9.71-16.10 g/dL, red blood cells (RBC) 3.66-5.79 × 106/mm3, hematocrit (HCT) 28.02%-46.75%, mean corpuscular volume (MCV) 64.02-95.65 fL, mean corpuscular hemoglobin (MCH) 21.57-33.80 pg, mean corpuscular hemoglobin concentration (MCHC) 31.60-36.56 g/dL, platelet count 155.35-454.30 × 103/mm3, and total white blood cells (WBCs) 2.90-10.76 × 103/mm3. Significantly higher median values were observed in males compared to females for hemoglobin, RBC, HCT, MCH, MCHC, and platelet distribution width. In contrast, females demonstrated significantly higher red cell distribution width-coefficient of variation, WBC, platelet, mean platelet volume, and plateletcrit than males. MCV showed no significant difference between genders.

The study's findings underscore the importance of establishing RIs for each region and specific gender population. RIs should also be established in other regions of Sudan to enhance clinical relevance and accuracy.

Lung cancer remains a primary contributor to cancer-related mortality globally. Red blood cell distribution width (RDW), a straightforward and cost-effective indicator, measures the variability in red blood cell size and is conventionally employed in hematological assessments for anemia differentiation. Nonetheless, limited research has explored the causal link between RDW levels and lung cancer incidence.

Initially, Mendelian randomization (MR) was employed to explore the underlying causal connection between RDW and lung cancer. To ensure the robustness of the MR findings, sensitivity analyses were conducted. Following this, the National Health and Nutrition Examination Survey (NHANES) database was utilized to further substantiate the influence of RDW on the prognosis of lung cancer.

The MR analysis revealed a significant association between RDW and lung cancer risk in the European population (OR IVW 1.11, 95% CI 1.03-1.20, p = 0.006; OR Weighted-median 1.16, 95% CI 1.03-1.31, p = 0.013; OR MR-Egger 1.14, 95% CI 1.00-1.30, p = 0.059). Furthermore, findings from the NHANES database suggested that lower RDW values are associated with improved prognosis in lung cancer patients (HR 2, 95% CI 1.07-3.74, p < 0.05).

Our study provides further evidence for the relationship between RDW levels and lung cancer, highlighting the potential significance of RDW as a biomarker for predicting lung cancer risk and prognosis.

How to screen beneficiary populations has always been a clinical challenge in the treatment of non-small-cell lung cancer (NSCLC) with immune checkpoint inhibitors (ICIs). Routine blood tests, due to their advantages of being minimally invasive, convenient, and capable of reflecting tumor dynamic changes, have potential value in predicting the efficacy of ICIs treatment. However, there are few models based on routine blood tests to predict the efficacy and prognosis of immunotherapy.

Patients were randomly divided into training cohort and validation cohort at a ratio of 2:1. The random forest algorithm was applied to select important variables based on routine blood tests, and a random forest (RF) model was constructed to predict the efficacy and prognosis of ICIs treatment. For efficacy prediction, we assessed receiver operating characteristic (ROC) curves, decision curve analysis (DCA) curves, clinical impact curve (CIC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared with the Nomogram model. For prognostic evaluation, we utilized the C-index and time-dependent C-index compared with the Nomogram model, Lung Immune Prognostic Index (LIPI) and Systemic Inflammatory Score (SIS). Patients were classified into high-risk and low-risk groups based on RF model, then the Kaplan-Meier (K-M) curve was used to analyze the differences in progression-free survival (PFS) and overall survival (OS) of patients between the two groups.

The RF model incorporated RDW-SD, MCV, PDW, CD3+CD8+, APTT, P-LCR, Ca, MPV, CD4+/CD8+ ratio, and AST. In the training and validation cohorts, the RF model exhibited an AUC of 1.000 and 0.864, and sensitivity/specificity of (100.0%, 100.0%) and (70.3%, 93.5%), respectively, which had superior performance compared to the Nomogram model (training cohort: AUC = 0.531, validation cohort: AUC = 0.552). The C-index of the RF model was 0.803 in the training cohort and 0.712 in the validation cohort, which was significantly higher than Nomogram model, LIPI and SIS. K-M survival curves revealed that patients in the high-risk group had significantly shorter PFS/OS than those in the low-risk group.

In this study, we developed a novel model (RF model) to predict the response to immunotherapy and prognosis in NSCLC patients. The RF model demonstrated better predictive performance for immunotherapy responses than the Nomogram model. Moreover, when predicting the prognosis of immunotherapy, it outperformed the Nomogram model, LIPI, and SIS.

Red blood cell distribution width (RDW)-to-albumin ratio (RAR) is a novel index. Its relationship with depression, a common and complex psychiatric disorder, remains unclear. This study utilized the National Health and Nutrition Examination Survey (NHANES) database to investigate this relationship.

Multivariate logistic regression, restricted cubic spline (RCS) regression, receiver operating characteristic (ROC) analysis, and sensitivity analyses were used to examine the relationship between RAR and depression based on NHANES data from 2011-2018. The study also used subgroup analyses and interaction tests to explore whether the relationship was stable across populations.

RAR was positively associated with depression in 18,150 participants aged ≥ 20 years. In fully adjusted models, each one-unit increase in RAR was associated with a 22% increase in the likelihood of depression [1.22 (1.05, 1.41)]. Participants in the highest quartile of RAR had a 30% higher risk of depression than those in the lowest quartile of RAR [1.30 (1.04, 1.63)]. Subgroup analyses revealed that the association between RAR and depression was significantly stronger among men, alcohol-drinking and high-income groups.

Higher baseline RAR was associated with an increased risk of depression in US adults and was more informative than RDW, albumin, and hemoglobin-to-RDW ratio (HRR). Further large-scale prospective studies are needed to analyze the role of RAR in depression. These findings emphasize that RAR can be a simple, reliable and cost-effective predictor of depression in clinical practice.

The association between blood parameters and gestational diabetes (GDM) is of renewed interest. Some blood cell parameters are assumed to be associated with GDM.

This meta-analysis was performed to assess the association of hematological indices in the first trimester of pregnancy and later development of GDM.

A comprehensive database search, including PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database, and Magiran, was conducted to identify potential peer-reviewed publications. The PECO framework was applied to evaluate the eligibility of all included studies. Standardized mean differences (95% CI), were calculated. Additionally, pooled odds ratios, summary estimates of sensitivity and specificity, positive and negative likelihood ratios, and diagnostic odds ratios (DOR) were determined.

The meta-analysis encompassed 33 studies involving a total of 247 107 pregnant women. Compared to control groups, GDM groups exhibited statistically significantly higher hemoglobin levels (standard mean difference: 0.50, 95% CI: 0.39-0.62), red blood cell (RBC) (0.23, 0.15-0.32), and hematocrit (0.44, 0.34-0.55). The pooled adjusted estimate (aOR:1.02, 1.006-1.03) indicated that the hemoglobin levels were significantly associated with an increased risk of GDM. GDM groups had significantly higher platelet count (0.280, 0.16-0.39) and white blood cells (WBC) counts, as well as (0.482, 0.377-0.58), lymphocytes (0.12, 0.025-0.22), neutrophils (0.541:0.404-0.679), and neutrophil-lymphocyte ratio (0.31, 0.20-0.43). In distinguishing women with GDM from the control group, the DOR was found to be 3.21 for the hemoglobin and 2.94 for the mean platelet volume.

Higher levels of RBC, platelet, and WBC counts during the first trimester of pregnancy were observed in women who subsequently developed GDM compared to control groups.

This study aims to construct and compare four machine learning models using the MIMIC-IV database to identify high-risk factors for multidrug-resistant organism (MDRO) infection in Ventilator-associated pneumonia (VAP) patients.

The study included 972 VAP patients from the MIMIC-IV database. Data encompassing demographic information, vital signs, laboratory results, and other relevant variables were collected. The class imbalance issue was addressed using the Synthetic Minority Over-sampling Technique (SMOTE). The dataset was randomly split into training and testing sets (8:2). LASSO regression and feature importance scores were used for feature selection. Clinical prediction models were built using logistic regression, XGBoost, random forest and gradient boosting machine. The performance of the models was evaluated through receiver operating characteristic(ROC) curve analysis.Model calibration was assessed using calibration curves and Brier scores. The effectiveness was evaluated through Decision Curve Analysis (DCA). SHAP was utilized for model interpretation.

Among 972 patients, 824 were non-MDROs-VAP and 128 were MDROs-VAP. Comparative analysis revealed statistically significant differences in various clinical parameters. XGBoost exhibited the best predictive performance, incorporating 20 features with an AUC of 0.831 (95 % CI: 0.785-0.877) on the test set. Calibration curves demonstrated robust consistency, corroborated by Decision Curve Analysis (DCA) affirming the clinical utility. SHAP analysis identified the most important features: red cell distribution width, duration of mechanical ventilation, anion gap, basophil percentage, and neutrophil percentage.

This study established and compared four machine learning models for MDROs infections in VAP patients. XGBoost was identified as the optimal predictor, and SHAP values provided insights into 20 independent risk factors, confirming its excellent predictive value.

VAP is a common infection in ICU patients with a heightened risk of MDRO and increased mortality. The recognition of high bias in existing models calls for future research to employ rigorous methodologies and robust data sources, aiming to develop and validate more accurate and clinically applicable predictive models for MDROs infections in VAP patients.

Post-stroke cognitive impairment (PSCI) is one of the main complications after stroke. The association between the hemoglobin-to-red cell distribution width ratio (HRR) and PSCI remains inadequately explored. Consequently, we performed a prospective study to assess whether HRR levels are associated with changes in cognitive function after acute ischemic stroke (AIS).

A total of 296 AIS patients were recruited. HRR was measured within 24 h of admission, and cognitive function was assessed using the Mini-Mental State Examination (MMSE) one month post-onset. Logistic regression analysis was performed to identify independent risk and protective factors for the occurrence of PSCI. Restricted cubic splines (RCS) were used to explore the dose-response relationship between HRR and PSCI.

129 of 296 participants (43.6%) developed cognitive impairment at 1 month. HRR in PSCI group was significantly lower than that in non-cognitive impairment group (P < 0.001). When HRR was taken as the categorical variable and with Q4 as the reference, the risk of PSCI in Q1 was the highest after adjusting multiple potential confounding factors (odds ratio [OR] = 2.702, 95% confidence interval [CI]= 1.222-5.977, P = 0.014). In addition, RCS curve exhibited that the relationship between HRR and PSCI was linear (P for nonlinear = 0.972, P for overall = 0.012). Subgroup analysis verified the stability of the results.

Reduced HRR levels were linked to an increased risk of cognitive impairment, indicating that HRR may serve as a predictive factor for PSCI.

A critical step in the metastatic cascade is the survival of circulating tumor cells (CTCs) within the bloodstream. Although interactions between CTCs and various hematopoietic cells have been described, the role of red blood cells (RBCs) remains underexplored. This study investigated the interactions between tumor cells and RBCs from breast and lung cancer patients, revealing significant phenotypic and functional changes in tumor cells, unlike interactions with RBCs from healthy donors. Tumor cell and patient-derived RBC co-cultures increased tumor cell attachment and induced morphological changes. RBC-primed tumor cells showed increased adhesion, disruption of the endothelial barrier, and invasiveness, both in vitro and in vivo. Global proteome changes, including actin remodeling and VASP accumulation at cell edges, promote directional migration. RBCs from patients with metastatic breast cancer also upregulate PAK4, enhancing migration and epithelial-mesenchymal transition, whereas PAK4 inhibition reduces these effects. Clinically, a higher red blood cell distribution width (RDW) in patients with metastasis is associated with increased CTC counts and poor outcomes. This study highlights the previously unrecognized role of RBCs in promoting metastatic behavior in cancer cells and suggests potential therapeutic targets, such as PAK4, to counteract these effects.

To study the clinical features of otitis media with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) and its differences with other forms of ANCA-associated vasculitis (non-OMAAV) and to explore whether routine blood tests could be beneficial to diagnosing OMAAV.

A retrospective study was conducted on 18 patients with OMAAV, 15 patients with non-OMAAV, and 23 patients with otitis media with effusion (OME). Basic and clinical information, laboratory data, and treatment outcomes were collected. The differences in the clinical characteristics between OMAAV and non-OMAAV patients were explored. Furthermore, the red cell distribution width (RDW), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were compared between OME and OMAAV patients. The optimal cutoff values for the routine blood indicators were estimated via receiver operating characteristic (ROC) curve analysis.

All eighteen OMAAV patients (100%) were initially misdiagnosed. Compared with non-OMAAV patients, involvement of nose, throat, and facial nerve was more common in OMAAV patients, whereas kidney damage was less common. However, neither of these differences was statistically significant. Relapse and disease-related death rates did not differ between the OMAAV and non-OMAAV groups. OMAAV patients presented with a lower MPV but a higher PLR and NLR than OME patients (P < 0.05).

OMAAV is often misdiagnosed as OME in elderly patients, but unlike OME, OMAAV is characterized by mixed hearing loss over its course. Low-cost routine blood tests may help otolaryngologists distinguish OMAAV from OME in the early stage. An abnormal middle ear condition with mixed hearing loss and a PLR ≥ 203.3 or NLR ≥ 4.7 may suggest a potential OMAAV diagnosis.

Consider that inflammatory factors are associated with short-term mortality in patients with acute myocardial infarction (AMI). In this retrospective analysis of 2,784 AMI patients from the Medical Information Mart for Intensive Care-IV database, we evaluated the impact of inflammatory markers on in-hospital mortality and predicted 30-day and 90-day outcomes. Patients were divided into groups based on in-hospital survival (n = 2,364) and mortality (n = 420). Analysis of initial hospital admission laboratory data, including inflammatory factors, revealed these factors as independent predictors of in-hospital mortality (Q4 of RDW: OR 1.96, NLR: OR 1.63, SII: OR 1.85, and SIRI: OR 2.23, all P < 0.05). Cox proportional hazards models confirmed their significance for predicting 30-day (Q4 of NLR: OR 1.83, SII: OR 1.86, and SIRI: OR 2.01, all P < 0.05) and 90-day mortality (Q4 of RDW: OR 1.46, NLR: OR 1.69, SII: OR 1.73, and SIRI: OR 1.72, all P < 0.05). Increasing levels of inflammatory markers correlated with higher odds and hazard ratios, as illustrated by Restricted Cubic Spline curves. Kaplan-Meier survival analysis showed better survival rates with lower inflammatory marker levels. Receiver operating characteristic curves demonstrated good predictive performance of individual inflammatory factors, with a new composite marker showing the highest predictive ability (AUC = 0.720). This study underscores the association of inflammatory factors with both hospital and short-term mortality in AMI patients.

Present knowledge about determinants of oncogenesis and cancer mortality remains incomplete, inconsistent, and controversial. We aimed to conduct an environment-wide association study (EWAS) to systematically investigate and tentatively validate correlations of environmental factors and biological metrics with prevalence and mortality of cancer.

All eligible participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and randomly split into training and testing sets by survey years. Environmental and biological exposures were assessed through either physical examinations or laboratory tests. We conducted survey-weighted logistic regression and COX proportional hazards regression models to investigate the relationships of 398 factors with cancer prevalence and 380 factors with cancer mortality, respectively. To adjust for multiple comparisons, positive findings in the training set (false discovery rate [FDR] < 5 %) were tentatively validated in the testing set (P value < 0.05). Random forest models were further fitted to evaluate the importance and diagnostic value of identified factors in relation to cancer prevalence.

Overall, 55,021 general participants and 5163 cancer survivors were included in the study of cancer prevalence and mortality, respectively. After adjusting potential confounders, we identified 7 environmental or biological factors (e.g. total bilirubin, testosterone, and beta-cryptoxanthin) associated with cancer prevalence in the general population, as well as 21, 8, and 6 indicators associated with all-cause (e.g. C-reactive protein), cancer-specific (e.g. blood selenium), and noncancer mortality (e.g. albumin) among individuals with cancer, respectively. EWAS-identified factors contributed to better performance of random forest models in predicting cancer prevalence.

Employing an EWAS approach, this study provided novel insights into potential targets for prevention and control of cancer.

Background/Objectives: This study aimed to investigate the prognostic value of the red cell distribution width-to-estimated glomerular filtration rate (RGR) ratio in patients hospitalized with chronic heart failure (CHF) and its potential interaction with NT-proBNP levels. By integrating anemia and renal dysfunction markers, the RGR may provide enhanced predictive insights regarding extended length of hospital stay (ELOS) > 7 days, in-hospital mortality, and 6-month all-cause mortality across specific CHF phenotypes. Methods: In this retrospective, single-center pilot observational study, 627 CHF admissions (January 2022-August 2024) were analyzed. Patients were classified according to the ESC guidelines into heart failure with reduced (HFrEF), mildly reduced (HFmrEF), or preserved ejection fraction (HFpEF). The RGR was calculated as red cell distribution width standard deviation (RDW-SD) divided by estimated glomerular filtration rate (eGFR). Predictive accuracy was evaluated using logistic regression, receiver operating characteristic (ROC) analyses, and stepwise Cox proportional hazard regression. Results: RGR was significantly higher in HFrEF than in HFpEF (p = 0.042) and predicted ELOS only in HFpEF (AUC = 0.619). In contrast, for in-hospital mortality, RGR achieved excellent discrimination in HFrEF (AUC = 0.945), outperforming RDW and NT-proBNP. In HFmrEF, RDW exhibited the highest predictive power (AUC = 0.826), whereas in HFpEF, NT-proBNP was the strongest predictor (AUC = 0.958), although RGR preserved good discrimination (AUC = 0.746). Across the entire cohort and HF phenotypes, RGR consistently emerged as a significant predictor in univariable analysis. In multivariable models, it improved the significance prognosis especially alongside NT-proBNP in the entire cohort and HFrEF. For 6-month all-cause mortality, RGR surpassed RDW in prediction in all HF phenotypes. Conclusions: The RGR independently predicts prolonged hospitalization, in-hospital, and 6-month mortality in CHF-often outperforming RDW and eGFR and being comparable to NT-proBNP, especially in HFrEF. These findings suggest that RGR may serve as a valuable risk stratification tool in CHF management.

Identifying reliable prognostic indicators is essential for the appropriate management of non-alcoholic fatty liver disease (NAFLD). Red blood cell distribution width (RDW) has been established as an inflammatory marker associated with cardiovascular outcomes. This study aimed to evaluate the association between RDW and both cardiovascular and all-cause mortality in individuals with NAFLD.

Data from 7,438 participants with NAFLD were analyzed, collected between 2005 and 2016 through the National Health and Nutrition Examination Survey (NHANES). Mortality data were retrieved from the National Death Index (NDI). Restricted cubic spline (RCS) analysis was used to illustrate the relationship between RDW and mortality risk, Weighted Cox proportional hazards models were used to assess the independent relationship between RDW and mortality risk. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive ability of RDW for survival outcomes.

During a median follow-up period of 124 months, 1,269 deaths were recorded, including 335 from cardiovascular causes. RDW positively correlated with both cardiovascular and all-cause mortality according to the RCS analysis. Participants were categorized into quartiles based on RDW levels. Those in the highest RDW quartile (Q4) demonstrated a significantly higher risk of cardiovascular mortality (HR 3.61, 95% confidence interval [CI]:2.17-6.02, P=0.009) and all-cause mortality (HR 2.29, 95% CI:1.72-3.06, P < 0.0001), according to the weighted Cox hazards models. Additionally, the area under the curve (AUC) for all-cause mortality at 3, 5 and 10 years was, 0.69, 0.67, and 0.66, respectively. For cardiovascular mortality, the AUCs were 0.70, 0.68, and 0.68, respectively.

Among patients with NAFLD, RDW was identified as an independent predictor of increased cardiovascular and all-cause mortality risk.

Age-related macular degeneration (AMD) is a leading cause of central vision impairment in middle-aged and older individuals. There is substantial evidence that AMD is associated with inflammation. The study aimed to investigate the association between the inflammatory marker, red blood cell distribution width/albumin ratio (RAR), and AMD.

Our study included 5,370 participants aged 40 years and older, using NHANES data from 2005 to 2008. Multivariable logistic regression analysis was conducted to examine the relationship between RAR and AMD in the study. Smooth curves and the piecewise linear regression model were used to determine whether the correlation was linear or non-linear. Additionally, subgroup analysis and interaction testing were performed.

We found a positive linear correlation between RAR and AMD, even after adjusting for covariates. Each unit increase in RAR corresponded to a 30% increase in the odds of AMD prevalence (OR = 1.3; 95% CI, 1.0-1.6). The odds of AMD prevalence were 1.7 times greater in the highest quintile (Q5) group than in the lowest quintile (Q1) group (OR = 1.7; 95% CI, 1.2-2.5). Higher RAR values, compared to lower values, were significantly associated with increased odds of AMD prevalence (p trend < 0.05). Subgroup analyses and interaction tests confirmed the stability of the findings.

This study found that there is a positive linear correlation between RAR and the odds of AMD prevalence in United States adults. Further research is necessary to clarify the specific physiological mechanisms underlying the relationship between RAR and AMD.

Cardiovascular disease (CVD) is the major cause of death globally, ranking first in terms of morbidity and mortality among non-communicable diseases. Red blood cell distribution width (RDW) and albumin (ALB) possess potential clinical application values. Moreover, the ratio of the two, namely RAR, might hold more advantages in disease diagnosis. However, the relationship between RAR and CVD in the general population has not been studied yet.

This represents a study encompassing 12,765 subjects. Logistic regression, Cox regression, restricted cubic splines, mediation analysis, and receiver operating characteristic curves were utilized to probe into the association between RAR and CVD, cardiovascular mortality rate and all-cause mortality rate.

A total of 12,765 participants were enrolled in this study, The mean age was 47.47 ± 16.33 years. Logistic regression revealed that RAR was positively correlated with the CVD. Furthermore, COX regression also illustrated that RAR was non-linearly and positively associated with both all-cause mortality rate and cardiovascular mortality rate (all-cause mortality: p-non-linear = 0.0322; cardiovascular mortality: p-non-linear = 0.0280). Additionally, the ROC results indicated that at various time points, RAR exhibited a stronger discriminatory capacity for cardiovascular mortality rate compared to all-cause mortality rate. HbA1c partially mediated the relationship between RAR and CVD. Subgroup analysis and interaction findings demonstrated that hypertension and race exerted a significant influence on the relationship between RAR and both all-cause mortality rate and cardiovascular mortality rate.

RAR was significantly linked to an elevated risk of CVD. The higher the RAR level, the greater the cardiovascular mortality rate and all-cause mortality rate. Thus, RAR could potentially be an independent risk factor for CVD. This underscores the crucial value of RAR in the discrimination and management of CVD.

The association of inflammation and iron deficiency could be related to up to 40% of anemia in young children.

To describe the anemia and iron deficiency in children and verify possible associations with dietary practices, nutritional status and inflammatory markers.

This cross-sectional study was conducted with one hundred and twelve children aged between 6 months and 3 years in Early Childhood Education Centers in Minas Gerais, Brazil. Nutritional status regarding iron and inflammatory markers was assessed using the reference values proposed by the World Health Organization.

Anemia and iron deficiency were observed in 58 (51.8%) and 89 (79.5%), respectively, of children evaluated. Hemoglobin values were directly associated with the z-score of height for age after adjusting for high-sensitivity C-reactive protein values (β-adjusted = 0.375; 95% CI 0.088 to 0.662; p = 0.011). The values of high-sensitivity C-reactive protein correlated directly with RDW (r = 0.202; p = 0.033), ferritin (r = 0.425; p < 0.001) and soluble transferrin receptor (r = 0.446; p < 0.001), and inversely with hemoglobin (r = -0.287; p = 0.002), serum iron (r = -0.580; p < 0.001) and transferrin saturation index (r = -0.528; p < 0.001). The ROC curve shows that RDW (AUC = 0.708; CI 95% 0.612 to 0.803) and soluble transferrin receptor (AUC = 0.588; 95% CI 0.481 to 0.694) were the variables that showed the better level of discrimination of anemia.

The prevalence of anemia was higher than in national studies, and there was a correlation between inflammatory markers and biomarkers of iron nutritional status.

Red blood cell distribution width (RDW) is an inflammatory marker potentially linked to stroke-associated pneumonia (SAP). This study assessed RDW's role in predicting SAP, mortality, and poor outcomes in acute ischemic stroke (AIS) patients treated with thrombolysis.

A retrospective analysis (2015-2022) of AIS patients treated with thrombolysis examined admission RDW levels. Outcomes included SAP, in-hospital (IHM) and 3-month mortality, and poor functional outcomes. Associations were analyzed using multivariable logistic regression, with predictive performance assessed via area under a receiver operating characteristic curve (AuROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) metrics.

Of 345 patients, 70 (20.3 %) developed SAP. A 1-SD increase in RDW was associated with SAP (adjusted odds ratio [aOR]: 1.73; 95 % CI: 1.27-2.35), IHM (aOR: 2.14; 95 % CI: 1.43-3.21), and 3-month mortality (aOR: 1.74; 95 % CI: 1.19-2.56). The association was stronger in non-diabetics and those under 65. Although RDW did not improve the AuROC for SAP or mortality predictions, it significantly improved the NRI and IDI (p < 0.05).

RDW is independently associated with increased risk of SAP, IHM, and 3-month mortality in AIS patients treated with thrombolysis, suggesting its potential as a prognostic marker.

Background Early diagnosis of liver cirrhosis in patients with chronic liver disease (CLD) can help delay/prevent complications and thereby improve survival. The currently available diagnostic modalities for the non-invasive assessment of hepatic fibrosis, especially FibroScan, are costly and not widely available, whereas various non-invasive scores for the assessment of fibrosis are cumbersome. Hence, we aimed to develop an easy and simple score for predicting cirrhosis in patients from Eastern India suffering from CLD with a better diagnostic accuracy. Methodology This cross-sectional, observational study was conducted between September 2019 and September 2021 in East India. Our study participants were patients who had CLD of etiologies such as alcohol-related liver disease, non-alcoholic fatty liver disease, chronic viral hepatitis B, chronic viral hepatitis C, primary biliary cholangitis, and autoimmune hepatitis, who had undergone FibroScan of the liver. All demographic details were noted, and the patients were subjected to physical examination, followed by hematological as well as biochemical investigations, including liver function tests. Non-invasive scores (such as aspartate aminotransferase (AST) to platelet ratio index (APRI) and Fibrosis-4 score (FIB-4) and red cell distribution width (RDW) to platelet ratio (RPR)) were computed, and their diagnostic accuracy for prediction of advanced fibrosis and cirrhosis were evaluated by receiver operating characteristic curve (ROC curve) analysis with comparison of area under the ROC curves. Pearson correlation and logistic regression analysis were also performed to study the association of these scores with advanced fibrosis and cirrhosis. Results The area under the ROC (AUROC) curve of the APRI score, FIB-4 score, RPR, and RPR × AST for prediction of advanced liver fibrosis was 0.817, 0.799, 0.706, and 0.811, respectively. Similarly, the AUROC of the above scores for the prediction of cirrhosis was 0.889, 0.858, 0.797, and 0.898. However, the product of RPR and AST was superior than APRI and FIB-4 for predicting cirrhosis. An RPR × AST value above the cut-off of 4.818 can help predict liver cirrhosis with 85.7% sensitivity and 85.5% specificity. Pearson correlation and logistic regression analysis also proved the association of these scores with liver fibrosis. Conclusions RPR is a simple, inexpensive, and easily available marker for predicting liver cirrhosis. Nevertheless, the variable RPR × AST can predict liver cirrhosis in patients with CLD with even greater diagnostic accuracy.

To investigate the association of red blood cell distribution width (RDW) to albumin ratio (RAR) with mortality in chronic obstructive pulmonary disease (COPD) patients.

We selected 1,652 patients with COPD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, who were categorized into four groups according to the RAR quartiles. Kaplan-Meier curves, restricted cubic splines and the Cox proportional hazard model were used to evaluate the associations between RAR and all-cause mortality and chronic lower respiratory disease (CLRD) mortality in the COPD patients. Subgroup analyses were performed to check the interaction of the different characteristics.

There were 640 deaths during follow-up, of which, 145 were from CLRD. Kaplan-Meier curves indicated COPD patients with higher RAR had significantly increased all-cause mortality and CLRD mortality. Multivariate Cox regression analyses showed HR of Q4 RAR was 2.88 (95% CI 2.18 - 3.81, p < 0.0001) for all cause-mortality and 3.39 (95% CI 1.76 - 6.53, p < 0.001) for CLRD mortality, compared with Q1 RAR. Restricted cubic splines analysis indicated a dose-response between RAR and risk of all-cause and CLRD mortality (p for non-linearity < 0.001).

RAR had an independent association with all-cause mortality, especially CLRD mortality, in COPD patients. RAR has potential as a novel and promising predictor to identify COPD individuals with high mortality risk.

Hemoglobin A1c (HbA1c) is an established tool in the diagnosis and follow-up of patients with diabetes. However, in some patients the interpretation of HbA1c results faces challenges due to additional biological variation or non-steady-state conditions. This study aimed to demonstrate the value of the L-HbA1c/HbA1c-ratio as a tool to flag HbA1c results, which do not reflect average glycemia "as expected" in routine clinical practice.

A total of 450 samples of unique patients were selected based on the L-HbA1c/HbA1c-ratio determined on a Tosoh G8 analyzer resulting in a group with a high ratio (≥0.50), a group with a low ratio (≤0.27) and a group with a normal ratio (0.27-0.50). The relationship between HbA1c and glycemic markers (fructosamine and random glucose) was established for all ratio groups. In a smaller cohort of type 1 diabetes patients, continuous glucose monitoring was used as glycemic marker.

The correlation between HbA1c and glycemia (random glucose and fructosamine) differs significantly between the ratio groups. For the same HbA1c level random glucose levels and protein-corrected fructosamine are higher in the high ratio group compared to the normal and low ratio groups, pointing to an underestimation of the glycemic status by HbA1c in patients with high L-HbA1c/HbA1c-ratios. The sensitivity of a high ratio to predict a glycation gap lower than -1.5 NGSP units is 82 % and the specificity is 65 %.

The results of this study reveal the usefulness of the L-HbA1c/HbA1c-ratio as an additional check in the interpretation of HbA1c results in order to detect HbA1c results not reflecting glycemia as expected.

The association between the hemoglobin-to-red cell distribution width ratio (HRR) and mortality in critically ill patients with heart failure (HF) and acute kidney injury (AKI) remains uncertain. This research focuses on exploring the association between HRR and both short-term and long-term all-cause mortality in these patients.

Participants were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized into tertiles based on HRR values. The primary endpoint was 28-days ICU all-cause mortality. Secondary endpoints included 28-days hospital and 90-days hospital all-cause mortality. Cox proportional hazards models and restricted cubic splines were used to analyze the association between HRR and mortality in patients with HF and AKI. Kaplan-Meier survival analysis estimated endpoint differences across tertiles.

A total of 7561 patients were included, with 55.5% being male (n=4199). Cox proportional hazards analysis showed a significant link between HRR and both short-term and long-term mortality in critically ill patients with HF and AKI. This association remained significant after adjusting for confounders. The restricted cubic splines model demonstrated a linear relationship between a higher HRR index and a reduced mortality risk. Kaplan-Meier survival analysis revealed significant differences in short-term and long-term mortality among the tertile groups.

The study results show a strong association between lower HRR and increased short-term and long-term mortality in critically ill patients with heart failure and AKI. HRR proves to be a valuable and cost-effective marker for identifying high-risk patients.

Upper gastrointestinal bleeding (UGIB) is a common condition in emergency departments (ED). The aim of this study is to evaluate the effectiveness of the red blood cell distribution width (RDW) to albumin ratio and three types of shock index (SI) as predictors of adverse outcomes in patients with UGIB in the ED.

The study was designed as a retrospective, single-center study, and patients were screened using electronic medical records. Glasgow Blatchford, RDW/albumin ratio, SI, modified SI (MSI), and age SI were calculated, and adverse outcomes were defined as ICU admission, red blood cell transfusion, in-hospital mortality, and 30-day mortality. The effectiveness of these parameters in predicting adverse outcomes in UGIB patients admitted to the ED was evaluated.

The study enrolled 174 patients, of whom 17.2% required admission to the ICU, 33.9% received red blood cell transfusions, and 10.3% died within 30 days. Patients with adverse outcomes had significantly higher SI, MSI, age SI, and RDW/albumin ratio values. All four indices were statistically significant predictors of adverse outcomes (area under the curve [AUC] SI: 0.676; AUC MSI: 0.706; AUC age SI: 0.778; AUC RDW/albumin: 0.787). Age SI showed significantly higher prognostic performance in predicting adverse outcomes than SI and MSI.

The present study suggests that SI, MSI, age SI, and RDW/albumin ratio may be useful in predicting adverse outcomes in patients with UGIB. The RDW/albumin ratio was effective in predicting mortality, while age SI showed a higher predictive ability for adverse outcomes compared to SI and MSI.

Objective The ratio of hemoglobin to red blood cell distribution width (Hb/RDW) is a simple and readily available tool associated with adverse outcomes in chronic heart failure (HF). However, the association between the Hb/RDW ratio and mortality in patients with acute decompensated HF (ADHF) is unclear. The goal of this study was to investigate the relationship between the Hb/RDW ratio and mortality in patients after ADHF. Methods This single-center study included clinical and laboratory data collected at baseline, with patients prospectively followed-up for a median period of 3.1 years. The patients were divided into two groups based on their median Hb/RDW ratio. Patients We evaluated 250 consecutive patients hospitalized for ADHF at Shinshu University Hospital between July 2014 and March 2019. Results In our study cohort [median age, 76 (66-83) years; 62.8% male], all-cause death was observed in 91 patients (incidence rate: 12.7 per 100 patient-years). A Kaplan-Meier analysis revealed that patients in the lower Hb/RDW ratio group (<0.24, n=131) had worse outcomes compared to those in the higher group (≥0.24, n=119) (cumulative incidence 44.1% vs. 19.5%, respectively; log-rank, p<0.001). After adjusting for demographics, HF severity, and laboratory biomarkers, a lower Hb/RDW ratio was significantly associated with a higher risk of mortality (hazard ratio, 1.89; 95% confidence interval, 1.04-3.45; p=0.038). Conclusion A lower Hb/RDW ratio is associated with an increased risk of mortality in patients after ADHF, thus indicating its potential utility in identifying patients at an elevated risk for future cardiovascular events.

To investigate the correlation between red blood cell distribution width (RDW) and negative remodeling (NR) in type B aortic dissection (TBAD).

This study involved the retrospective analysis of clinical data of 264 patients with nonsurgical TBAD admitted to our hospital between September 2015 and September 2022. Patients underwent regular follow-up after discharge, including periodic chest and abdominal aortic computed tomography angiography. Aortic dissection false lumen expansion was evaluated based on computed tomography angiography images taken at the final follow-up. Patients were divided into two groups based on the occurrence of NR in aortic dissection: NR and non-NR groups.

A total of 264 patients with an average age of 60 years (63.6% male), with a mean follow-up duration of 53.5 months and a survival rate of 87.9% (232/264 patients), were enrolled. During the follow-up period, 87 patients (33.0%) developed NR of the aortic dissection (NR group). Twenty-four patients in the NR group underwent surgery, which was significantly higher than the number of patients in the non-NR group (27.6% vs 16.9%). One patient in each group died of aortic rupture. RDW levels were significantly higher in the NR than the non-NR group (13.7 ± 1.2 vs 12.7 ± 1.0; P < .001). Spearman's correlation analysis identified a positive correlation between RDW and NR (r = 0.368; P < .001). Multivariate logistic regression analysis identified elevated RDW (odds ratio, 3.910; P < .001) as an independent risk factor for NR. The receiver operating characteristic curve indicated that a cutoff point of RDW >13.7% achieved an area under the curve for prediction of 0.770, sensitivity of 75.1%, and specificity of 93.2% (95% confidence interval, 0.722-0.818; P < .001).

RDW is a simple, inexpensive, and effective predictive marker of NR in TBAD. Herein, we identified that an RDW of >13.7% is a risk factor for NR in patients with nonsurgical TBAD during follow-up. This limit may provide a reliable basis for assessing the need for surgical intervention, optimizing prognosis evaluation, and making clinical decisions, ultimately improving the long-term survival and quality of life of patients.

To study the relationship between red blood cell distribution width (RDW) and short-term mortality of hip fracture in middle-aged and older adults.

A retrospective cohort of electronic medical records at a single hospital over a 2-year period between 2020 and 2021. We received the records of 233 patients aged > 50 years who suffered from hip fracture. the clinical data including patients demographics, comorbidities at the time of admission, type of surgery, blood examination, 3-months mortality, 6-months mortality and 1-year mortality. the relationship between RDW and short-term mortality of hip fracture were analyzed. the cohort was then divided into two groups based on their RDW levels at the time of admission: low (RDW < 13.6%) and high (RDW ≥ 13.6%).

Results the mean age was 78.03 ± 12.09 years; 64.81% were woman. At admission, 80 patients (34.33%) had high RDW levels and 153 patients (65.67%) had low RDW levels. there were no statistically significant differences between the groups with regard to sex, type of operation, duration of surgery and hospitalization length. Patients with high RDW had more comorbidities when compared to patients with low RDW levels (p < 0.05). All-cause mortality was higher for patients with high RDW levels, at 3 months (p < 0.05), 6 months (p < 0.05), and 12 months (p < 0.05).

RDW is significantly related with short-term mortality in hip fracture. The higher RDW, the higher risk of mortality.

Some studies have reported conflicting results regarding the prognostic value of red blood cell distribution width (RDW) for patients with intracranial hemorrhage (ICH). This meta-analysis aims to investigate the association between RDW and all-cause mortality in ICH.

We systematically searched the following databases, including PubMed, EMBASE, Cochrane library, and Web of Science, for all studies assessing the prognostic value of mortality in patients with ICH from inception to December 2023. We calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs).

A total of 7 studies evaluated the association of RDW and all-cause mortality. A higher RDW levels were significantly associated with all-cause mortality (OR = 1.52; 95% CI = 1.22 to 1.89; P = .0002; I2 = 76%).

Therefore, RDW is a valuable prognostic marker for the risk of all-cause mortality in patients with intracranial hemorrhage.

Acute ischemic stroke (AIS) is a prevalent acute condition among older individuals. This study is the first investigation of the link between the HRR and unfavorable three-month outcome in older AIS patients.

This secondary research used data from a sample of 1,470 older AIS patients collected from a South Korean hospital between January 2010 and December 2016. Multiple imputation was applied to account for absent values. Binary logistic regression analysis was used to examine the relationship between the baseline HRR and adverse outcome at three-month. Restricted cubic spline analysis was employed to evaluate the correlation between HRR levels and adverse outcome. Interaction tests were performed to discern variations among subgroups.

At 3 months, the overall incidence of adverse events was 31.43%, with a median HRR of 9.49. Compared to those with a lower HRR (Q1), the adjusted odds ratios (ORs) for the HRR in Q2, Q3, and Q4 were 0.61 (95% CI: 0.41-0.92, p = 0.017), 0.49 (95% CI: 0.31-0.78, p = 0.003), and 0.54 (95% CI: 0.31-0.92, p = 0.025), respectively. The correlation between the HRR and adverse outcome was non-linear (p < 0.05). An inflection point threshold of 10.70 was established via RCS analysis. Each 1-unit increase in HRR on the left side of the infection point was associated with a 24.0% decrease in the likelihood of adverse outcomes (OR = 0.76, 95% CI: 0.66-0.86, p < 0.001). ROC analysis revealed that HRR had the highest AUC (0.64, 95% CI: 0.61-0.67), followed by hs-CRP (0.60, 95% CI: 0.57-0.63), FPG/HbA1c (0.59, 95% CI: 0.55-0.63), and WBC (0.55, 95% CI: 0.51-0.58).

A lower HRR was correlated with a higher risk for adverse outcome in older AIS patients.

The red blood cell distribution width to albumin ratio (RAR) is a novel comprehensive biomarker of inflammation and nutrition, which has emerged as a reliable prognostic indicator for adverse outcomes and mortality in patients with various diseases. However, the association between RAR and low cognitive performance in older adults remains unclear. This study aims to investigate the relationship between RAR and low cognitive performance among older adults in the United States.

This study, a retrospective analysis, included 2,765 participants aged 60 years and older from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. Low cognitive performance was assessed using word learning subset from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Digit Symbol Substitution Test (DSST), and the Animal Fluency Test (AFT). Low cognitive performance was defined as scores below the lowest quartile in each cognitive test. The association between RAR and low cognitive performance was evaluated using weighted multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses.

After adjusting for all potential confounders, RAR was independently and linearly positively associated with both low DSST performance and low AFT performance. Specifically, compared to participants in the first quartile of RAR, those in the fourth quartile had adjusted ORs (95% CIs) of 1.81 (1.03, 3.20) for low DSST performance and 1.68 (1.05, 2.67) for low AFT performance. Subgroup analysis did not reveal significant interactions between stratification variables.

RAR is significantly linearly positively associated with low cognitive performance. Maintaining a lower RAR may be a crucial strategy for mitigating the risk of cognitive decline in the elderly population.

Chronic obstructive pulmonary disease (COPD) complicated by atrial fibrillation (AF) in ICU patients is associated with higher risks of adverse outcomes. The red cell distribution width to albumin ratio (RAR), may predict mortality in critical illness, yet its link to 28-day mortality in ICU patients with COPD and AF remains unclear.

This retrospective cohort study analyzed 693 ICU patients with COPD and AF from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, grouped by RAR tertiles. The primary endpoint was 28-day mortality, with secondary endpoints including 90-day, 365-day, and ICU mortality. Multivariate cox models estimated hazard ratios (HRs) for mortality, while restricted cubic spline regression assessed the linearity of the RAR-mortality relationship. Kaplan-Meier curves compared survival across tertiles, and subgroup analyses explored RAR's impact across age, gender, race, and comorbidities.

Our study included 693 ICU patients with both COPD and AF, with an average age of 74.9 years. The 28-day mortality was 30.7%. Patients in the highest RAR tertile had significantly worse 28-day survival (p < 0.0001). Higher RAR was linearly associated with increased 28-day mortality (p for non-linearity > 0.05), with each 1-unit increase in RAR linked to an 18% rise in mortality risk (95% CI: 1.08-1.29). Sensitivity analyses confirmed RAR's relevance for 90-day, 365-day, and ICU mortality.

RAR is independently associated with 28-day mortality in COPD patients with AF. Elevated RAR levels correlate with higher 28-day mortality rates in this population.

Not applicable.

Reference intervals (RI) are an essential tool to support clinical decisions. These may have intra- and inter-individual variations associated with genetic differences and environmental factors. Given that Chile is a multiethnic territory, studying these variables is even more relevant. The purpose of this study was to establish RI for various hematological parameters in the Chilean population and the Mapuche ethnic group.

A sample of 356 adult individuals (aged 18-65 years), of which 146 belonged to the Mapuche ethnic group, was selected using the indirect a posteriori method from the database of the UC Temuco Clinical Laboratory. The analysis was conducted by sex and ethnicity. The Tukey fences method was employed to detect outliers, and the RIs were established through the non-parametric method recommended by the IFCC.

The median age for the overall sample of the general population was 35 years (female) and 36 years (male). Differences (p<0.05) were found by sex in parameters dependent on hemoglobin and platelets counts. In the analysis by ethnicity, the parameters of RBC, HGB and HCT presented significant differences (p<0.0001).

This study shows that hematological RI vary according to sex and ethnicity, which must be considered in a multiethnic population. This understanding enhances our comprehension of the individual characteristics of each person and facilitates more accurate clinical interpretation.

Sepsis is a clinical condition characterized by high morbidity and mortality. Several prognostic markers have been evaluated to identify patients with severe sepsis. The red cell distribution width (RDW) is a cost-effective and widely accessible laboratory test to predict mortality across various medical conditions. This research aimed to evaluate the role of RDW as a predictor of mortality in sepsis patients and compare its predictive value with that of serum lactate levels and the qSOFA (quick Sequential Organ Failure Assessment) score.

This prospective observational study enrolled sepsis patients admitted to the Medicine Department at the Indira Gandhi Institute of Medical Sciences between March and August 2024. The study evaluated the discriminatory ability of RDW, serum lactate levels, and qSOFA score for predicting mortality by calculating the ROC-AUC (receiver operating characteristic area under the curve).

Out of 100 eligible patients, 97 had been incorporated into the final analysis. The mean RDW was significantly elevated among the non-survivors, and it had been recognized as an independent predictor of 30-day mortality (OR=2.91, (1.56; 5.42), p < 0.001). For predicting 30-day mortality, the AUC values were as follows: RDW at 0.878 (p < 0.001), lactate at 0.719 (p < 0.001), and qSOFA score at 0.837 (p < 0.001). The cutoff value for RDW was established at 14.15%.

RDW was significantly associated with 30-day mortality in sepsis patients and was found to be an independent prognostic marker for predicting mortality. Its mortality discriminative ability was comparable to that of the qSOFA score but superior to that of lactate.

Osteoporosis imposes significant burdens. Early detection of high-risk individuals through simple indicators can greatly improve prognosis. Red cell distribution width (RDW), a standard component of a complete blood count, shows promise, yet remains underexplored. This cross-sectional study aimed to investigate the association between RDW and femoral neck and spinal bone mineral density (BMD).

Participants aged 20-79 years from the 2005-2010, 2013-2014, and 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) were included. BMD was measured using dual-energy X-ray absorptiometry (DXA).

A total of 13,029 participants were included, comprising 6684 men, 3238 postmenopausal women, and 3107 premenopausal women, with the sample weighted to represent 98,712,128 people. After adjusting for covariates, RDW exhibited a negative association with femoral neck BMD in both men (β = -0.006; 95% CI: -0.010 to -0.002; p = 0.0053) and postmenopausal women (β = -0.005; 95% CI: -0.010 to -0.000; p = 0.0413). Subgroup and sensitivity analyses supported the robustness of these findings. A negative association between RDW and spinal BMD in men approached significance (β = -0.004; 95% CI: -0.008 to 0.000; p = 0.0557). Persistent trends were observed for RDW with spinal BMD in postmenopausal women and with both femoral neck and spinal BMD in premenopausal women.

Our study suggests a negative association between RDW and femoral neck BMD in both men and postmenopausal women. These findings highlight the potential of RDW as a marker for identifying individuals at higher risk of osteoporosis.

Red blood cell (RBC) indices provide information on the size and haemoglobin content of erythrocytes. The RBC distribution width (RDW) is an index of size variability of the circulating RBC population. The correlation between various diseases and RDW in dogs has been demonstrated. Some studies have evaluated RDW in dogs with myxomatous mitral valve disease (MMVD), and conflicting results have been reported.

We aimed to evaluate the association between RBC indices, complete blood cell counts (CBC), and serum biochemical and echocardiographic variables in small-breed dogs with MMVD.

RBC indices, CBC, and serum biochemical and echocardiographic variables were retrospectively investigated in 102 client-owned dogs with MMVD at various disease stages.

RBC indices were not statistically significant among groups (control group, compensated group, decompensated group). RDW had a significant positive correlation with haematocrit (Hct) (correlation coefficient, 0.452) and a negative correlation with MCH (correlation coefficient, -0.498) and MCV (correlation coefficient, -0.357). The end-diastolic volume index, fractional shortening (%), and left atrial-anteroposterior diameter normalised for body weight were echocardiographic variables that affected MMVD severity.

We observed no correlation between RBC indices and MMVD. However, conflicting results have been reported in several other studies; thus, further studies should be considered.

Acute pancreatitis is a potentially life-threatening inflammatory condition with variable clinical presentations. Early risk stratification remains challenging despite existing scoring systems. The red blood cell distribution width-to-albumin ratio (RAR) has emerged as a potential prognostic biomarker in inflammatory conditions. This systematic review and meta-analysis aimed to evaluate the association between admission RAR and outcomes in acute pancreatitis. We conducted a comprehensive literature search and identified five retrospective studies meeting the inclusion criteria. Meta-analysis was performed to assess the relationship between RAR and mortality as well as disease severity in acute pancreatitis patients. Pooled analysis demonstrated that elevated RAR was significantly associated with increased mortality risk (risk ratio (RR): 2.11, 95% confidence interval (95% CI): 1.35-3.30) with moderate heterogeneity (I²: 46%). When comparing disease severity, mean RAR values were significantly lower in mild acute pancreatitis compared to severe cases (mean difference (MD): -1.78, 95% CI: -2.09 to -1.46), also with moderate heterogeneity (I²: 44%). This meta-analysis suggests that RAR, a simple and cost-effective biomarker available from routine blood tests, may serve as a valuable prognostic indicator for mortality and severity in acute pancreatitis. Despite having comparatively lower discriminative ability than conventional scoring systems, RAR offers advantages in terms of rapid assessment and cost efficiency. However, limitations include the small number of included studies, their retrospective nature, and heterogeneity in study settings. Further prospective studies are warranted to validate these findings.

Statistically, 30% of asthma deaths occur among asthmatics with insignificant symptoms, which creates a social burden. We aimed to analyze the role of erythrocyte distribution width (RDW) in the prognosis of asthma, especially in patients with insignificant symptoms. We included 3039 adult (≥ 20 years) asthma patients from the National Health and Nutrition Examination Survey (NHANES). Cox regression was used to assess the association between RDW and long-term mortality. We adjusted three models to reduce potential bias. Subgroup analysis is used to evaluate specific populations. In addition, receiver operating characteristic (ROC) curves were used to analyze the predictive effect of RDW on asthma mortality. After a mean follow-up of 130 months, we found a positive correlation between RDW and long-term mortality. After aliquoting RDW into thirds, the high RDW (RDW ≥ 13.0%) group had higher all-cause mortality (HR 1.66, 95% CI 1.18-2.34) and respiratory mortality (HR 8.69, 95% CI 2.03-37.3). There was a significant interaction of RDW in the male and wheezing subgroups for respiratory mortality. Combining RDW and wheezing, we found that patients with high RDW and wheezing had the most increased respiratory mortality, and patients with high RDW but no wheezing also had higher mortality. Furthermore, the area under the curve of the RDW in predicting respiratory death in asthmatics was greater than 80%. Our study showed an association between high RDW and poor prognosis in asthma patients. In combination with wheezing symptoms, RDW is expected to be a biomarker for asthma management.

Acute coronary syndromes (ACS) are one of the most common causes of morbidity and mortality worldwide. Primary percutaneous coronary intervention (pPCI) is the main treatment strategy to restore myocardial perfusion. However, the no-reflow phenomenon (NRP) may block coronary flow. The present study focused on assessing and contrasting predictive parameters for NRP in ACS patients. Our research is a retrospective analysis. We assessed the parameters significantly associated with NRP using Cox regression and Receiver operating characteristic (ROC) Curve analysis. The study included 5122 patients who met the criteria. The average age of the patients was 63.9 + 13.2, and 74.4% were male. It was observed that NRP developed in 1.8% of all patients. Age, hemoglobin (Hb), white blood cell (WBC), glucose and low density lipoprotein cholesterol (LDL-C) were determined to be independent predictors of NRP. The power of these parameters to predict NRP was similar, and WBC was the most predictive (Area Under Curve (AUC): 0.605 95% CI: 0.539-0.671, P = .001). We believe that the use of these simple, practical, and routinely used hematological and biochemical parameters will help us predict the risk of developing NRP before pPCI. This information should improve management.

Red blood cell volume distribution width (RDW) and albumin (Alb) have been proved to be predictors of mortality in various diseases, such as acute pancreatitis (AP). However, until now the relationship between RDW to Alb ratio (RAR) and mortality in AP has not been fully elucidated. Therefore, this study aims to evaluate the relationship between RAR and all-cause mortality in AP.

Patients with AP in the Critical Care Medical Information Market (MIMIC-IV) database who met criteria were included in this retrospective study. Associated baseline data was obtained, cleaned and analyzed. Kaplan Meier (K-M) survival curve and Cox proportional hazards regression model were utilized to evaluate the relationship between RAR and all-cause mortality. Restricted Cubic Spline (RCS) was used for exploring how hazard ratio (HR) changes as RAR varied. Additionally, Receiver Operating Characteristic (ROC) analysis and subgroup analysis were conducted to assess the predictive value and to explore the significance of RAR in different populations.

499 patients were included in this study. Survival curve showed that patients with RAR > 5.14 had higher mortality rate at 7-day (d), 14-d, 21-d, 28-d, 90-d, 180-d and 1-year (y). The univariate and multivariate Cox models revealed an independent association between high-level RAR and all-cause mortality at 28-d, 90-d and 1-y. RCS showed that RAR became a risk factor when exceeding 5.14. RAR only had linear relationship with mortality at 1-y after adjusting for the potential confounders. Subgroup analysis suggested that increased RAR caused higher risk of death in male, non-white people or those patients without respiratory failure (RF). ROC analysis indicated that compared with other parameters such as SOFA score, RAR exhibited higher efficiency in predicting in-hospital and all-cause mortality at 14-d, 21-d, 28-d, 90-d. Combined RAR with BISAP, RAR-modified BISAP showed superiority in predicting short-term mortality (28-d).

For patients with AP in ICU, RAR has a strong association with short- and long-term prognosis. Especially, RAR is a promising indicator for short-term all-cause mortality in patients with AP. For males, non-white patients and those without RF, elevated RAR may be a more dangerous signal of mortality.

Red blood cell distribution width (RDW) is a prognostic factor in various disorders. This study aimed to assess the prognostic value of RDW in patients undergoing amputation for diabetic foot. We retrospectively analyzed data on 415 patients who underwent diabetic foot amputation between January 2009 and January 2019. After establishing an optimal cutoff value of preoperative RDW for all-cause mortality, univariable and multivariable analyses with Cox proportional hazard model for survivorship and logistic regression analysis for prolonged hospital length of stay (> 30 days) were performed to identify significant prognostic factors. A preoperative RDW of 14.5% was the optimal cutoff value for predicting all-cause mortality. RDW ≥ 14.5% was significantly associated with increased all-cause mortality (hazard ratio, 2.55; 95% confidence interval [CI], 1.55-4.19; P < 0.001) on multivariable Cox proportional model analysis. Preoperative RDW ≥ 14.5% was also associated with a prolonged hospital length of stay after surgery (odds ratio, 2.17; 95% CI, 1.29-3.66; P = 0.004). Higher preoperative RDW was an independent predictive factor for increased all-cause mortality and prolonged hospital length of stay after diabetic foot amputation. These results suggest that RDW may be a useful laboratory parameter for risk stratification in patients undergoing amputation for diabetic foot.