The relationship between red cell distribution width/albumin ratio and one-year mortality risk in elderly patients with sepsis
Lyu Ziwen
Gu Junhui
Gao Zhuo
Liu Dong
Abstract：Objective To investigate the association between red cell distribution width/albumin ratio(RAR)and one-year mortality risk in elderly patients with sepsis.Methods This study was a retrospective observational cohort study by using the data from the Medical Information Mart for Intensive Care(MIMIC)Ⅳ2.2.The primary outcome was death within one year.Firstly,the importance of RAR was determined by the Boruta algorithm.Multivariate Cox regression analysis and restricted cubic spline regression curve were used to assess the association of RAR with mortality within one year in elderly patients with sepsis.Kaplan-Meier survival analysis was used to estimate the differences in endpoint events.Finally,we further verified the robustness and reliability of the study results through detailed subgroup analysis.Results The study included 3 018 participants aged 65 years or older.The one-year mortality was 60.8％.Multivariate Cox regression showed that RAR was independently associated with one-year mortality risk in elderly patients with sepsis(HR=1.206,P＜0.0001).According to Kaplan-Meier survival curve analysis,the one-year mortality in the high RAR group was significantly higher than that in the low RAR group.The restricted cubic spline regression model showed that the one-year mortality in the elderly patients with sepsis increased linearly with the increase of RAR.Finally,subgroup analysis showed an interaction of acute respiratory failure and RAR with one-year mortality risk(P=0.0477).In addition,the Boruta algorithm indicated that RAR was an important feature of adverse outcomes in elderly patients with sepsis.Conclusions High levels of RAR are associated with an increased risk of death within one year in elderly patients with sepsis,and RAR has good predictive value for the one-year mortality risk in elderly patients with sepsis.
Keywords：Old peopleSepsisRed cell distribution width/albumin ratioOne-year mortalityCox regression modelRestricted cubic spline regression curveKaplan-Meier survival analysisInteraction
Publication Date：2025-01-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 33-39 )