Association Between the Red Blood Cell Distribution Width-to-Albumin Ratio, Nursing Notes, and the Length of Hospital Stay in Iron Deficiency Anaemia Complicated With Congestive Heart Failure Patients.

AIMS: To evaluate the influence of the red blood cell distribution width-to-albumin ratio (RAR) and sentiment scores from nursing notes on the length of hospital stay (LOS) and mortality risk among iron deficiency anaemia (IDA) patients with congestive heart failure (CHF).

DESIGN

A retrospective study.

METHODS

Data for this retrospective research were obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Multivariable logistic regression analysis was conducted to determine the individual associations of RAR and sentiment subjectivity scores with 7-day hospital LOS. Additional multivariable logistic analyses and subgroup analyses were performed to explore the joint effect of RAR and subjectivity combined on 7-day hospital LOS.

RESULT: 655 IDA patients with CHF were included. Among them, 384 patients (58.63%) had a hospital LOS exceeding 7 days. Multivariable logistic regression revealed that the RAR and the scaled subjectivity were linked to the 7-day hospital LOS. The combination of RAR and subjectivity was significantly associated with the 7-day hospital LOS. Compared to the low subjectivity and low RAR group, the group with high subjectivity and high RAR was identified as a risk factor for a 7-day hospital LOS.

CONCLUSION

High RAR and high subjectivity were associated with a higher risk of 7-day hospital LOS in IDA patients with CHF, but the two predictors did not interact. Prospective validation of RAR-based risk stratification and of joint RAR-subjectivity classification as an exploratory descriptive tool is warranted before clinical implementation.

IMPLICATIONS FOR PATIENT CARE: Nurses may use RAR and nursing note subjectivity as complementary information to identify patients at higher risk of prolonged hospitalisation and prioritise nursing assessment and care planning accordingly.

REPORTING METHOD: Adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.