Wang JN, Hu ZS, Yu YW, Peng XH. Red blood cell distribution width to albumin ratio is correlated with prognosis of patients in coronary care unit. World J Cardiol 2025; 17(2): 103273 [DOI: 10.4330/wjc.v17.i2.103273]
Corresponding Author of This Article
Yong-Wei Yu, Assistant Professor, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. yuyongwei@zju.edu.cn
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jiao-Ni Wang, Xiao-Hui Peng, Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Jiao-Ni Wang, Ze-Song Hu, Yong-Wei Yu, Department of Cardiology, The Second Affiliated and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 312500, Zhejiang Province, China
Yong-Wei Yu, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Co-corresponding authors: Yong-Wei Yu and Xiao-Hui Peng.
Author contributions: Peng XH and Yu YW guided the idea of the manuscript and contributed equally as co-corresponding authors; Wang JN completed database processing, data export and manuscript writing; Hu ZS was responsible for the final compilation of pictures and tables.
Institutional review board statement: All data extracted in this study complied with the latest guidelines issued by Medical Information Mart for Intensive Care III database version 1.4 and did not require separate ethical approval or informed consent.
Informed consent statement: All data extracted in this study complied with the latest guidelines issued by Medical Information Mart for Intensive Care III database version 1.4and did not require separate ethical approval or informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Our research used the Medical Information Mart for Intensive Care III database version 1.4 (MIMIC III v1.4). MIMIC III was a publicly available single-center critical care database, which was approved by the Institutional Review Boards of Beth Israel Deaconess Medical Center (BIDMC, Boston, MA, United States) and the Massachusetts Institute of Technology (MIT, Cambridge, MA, United States).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Wei Yu, Assistant Professor, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. yuyongwei@zju.edu.cn
Received: November 14, 2024 Revised: December 26, 2024 Accepted: January 23, 2025 Published online: February 26, 2025 Processing time: 103 Days and 15.9 Hours
Abstract
BACKGROUND
As red blood cell distribution width (RDW) and albumin have been shown to be independent predictors of mortality from various diseases, this study aimed to investigate the effect of the RDW to albumin ratio (RA) as an independent predictor of the prognosis of patients admitted to the coronary care unit (CCU).
AIM
To use the RDW and albumin level to predict the prognosis of patients in the CCU.
METHODS
Data were obtained from the Medical Information Mart Intensive Care III database. The primary outcome was 365-day all-cause mortality, whereas the secondary outcomes were 30- and 90-day all-cause mortality, hospital length of stay (LOS), and CCU LOS. Cox proportional hazards regression model, propensity score matching, and receiver operating characteristic curve analyses were used.
RESULTS
The hazard ratio (95% confidence interval) of the upper tertile (RA > 4.66) was 1.62 (1.29 to 2.03) when compared with the reference (RA < 3.84) in 365-day all-cause mortality. This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis. Similar trends were observed for the secondary outcomes of hospital and CCU LOS. Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment (SOFA) scores, and the C-statistic was higher than that of the SOFA scores (0.733 vs 0.702, P < 0.001).
CONCLUSION
RA is an independent prognostic factor in patients admitted to the CCU. RA combined with the SOFA score can improve the predictive ability of the SOFA score. However, our results should be verified in future prospective studies.
Core Tip: This study identifies the red blood cell distribution width to albumin ratio (RA) as an independent predictor of prognosis in coronary care unit patients. Higher RA levels (RA > 4.66) are linked to increased 365-day mortality and longer hospital stays, even after adjusting for clinical factors. Combining RA with the sequential organ failure assessment score significantly improves mortality prediction (C-statistic: 0.733 vs 0.702, P < 0.001). These findings suggest RA can enhance early risk assessment, supporting better clinical decision-making in critically ill patients.
