Hematology (Amsterdam, Netherlands) · 2026
Association between red cell distribution width to albumin ratio and all-cause mortality in critically ill patients with myelodysplastic syndrome: a retrospective cohort study.
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Huang Zicong, Liu Shan, Guo Zhi
Аннотация
BACKGROUND: The red cell distribution width to albumin ratio (RAR) has emerged as a novel, easily calculated biomarker demonstrating prognostic value across various diseases. However, the relationship of RAR for all-cause mortality risk in critically ill patients with myelodysplastic syndromes (MDS) remains unclear.
OBJECTIVES: To explore the association between RAR and all-cause mortality in critically ill patients with MDS.
METHODS: This retrospective cohort study utilized patient data from the MIMIC-IV database. The study population was patients with MDS admitted to ICU for the first time. The main outcome was all-cause mortality at 28-day, 90-day, and 365-day. The association between RAR and all-cause mortality was evaluated using Cox proportional hazards regression analysis. Restricted Cubic Spline (RCS) regression was employed to test for any non-linear relationship between RAR levels and the mortality risk.
RESULTS: Patients in the high RAR group showed significantly worse survival rates across time points of 28-day, 90-day, and 365-day compared to the low RAR group (log-rank test, all P < 0.001). In the adjusted multivariable Cox regression model, elevated RAR as a continuous variable was significantly associated with an increased risk of all-cause mortality: 28-day (HR = 1.18; 95% CI: 1.08-1.29; P < 0.001), 90-day (HR = 1.18; 95% CI: 1.09-1.27; P < 0.001), and 365-day (HR = 1.17; 95% CI: 1.10-1.25; P < 0.001). RCS analysis confirmed a positive but non-linear association between increasing RAR levels and heightened mortality risk.
CONCLUSIONS: RAR, a readily available composite biomarker, is associated with all-cause mortality in critically ill patients with MDS.
OBJECTIVES: To explore the association between RAR and all-cause mortality in critically ill patients with MDS.
METHODS: This retrospective cohort study utilized patient data from the MIMIC-IV database. The study population was patients with MDS admitted to ICU for the first time. The main outcome was all-cause mortality at 28-day, 90-day, and 365-day. The association between RAR and all-cause mortality was evaluated using Cox proportional hazards regression analysis. Restricted Cubic Spline (RCS) regression was employed to test for any non-linear relationship between RAR levels and the mortality risk.
RESULTS: Patients in the high RAR group showed significantly worse survival rates across time points of 28-day, 90-day, and 365-day compared to the low RAR group (log-rank test, all P < 0.001). In the adjusted multivariable Cox regression model, elevated RAR as a continuous variable was significantly associated with an increased risk of all-cause mortality: 28-day (HR = 1.18; 95% CI: 1.08-1.29; P < 0.001), 90-day (HR = 1.18; 95% CI: 1.09-1.27; P < 0.001), and 365-day (HR = 1.17; 95% CI: 1.10-1.25; P < 0.001). RCS analysis confirmed a positive but non-linear association between increasing RAR levels and heightened mortality risk.
CONCLUSIONS: RAR, a readily available composite biomarker, is associated with all-cause mortality in critically ill patients with MDS.