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Association between red cell distribution width-to-albumin ratio and prognostic outcomes in pediatric intensive care
Rui Jing1, Baolong Yu1, Chenchen Xu1
1Department of Pediatrics, Weifang People's Hospital, Weifang, Shandong, China.
Insights
The Red Cell Distribution Width-to-Albumin Ratio (RAR) is linked to increased mortality in pediatric intensive care unit (PICU) patients. Higher RAR levels correlate with higher 28-day, 90-day, and in-hospital mortality rates.
Area of Science:
- Pediatric critical care medicine
- Clinical biochemistry
- Biomarker research
Background:
- The Red Cell Distribution Width-to-Albumin Ratio (RAR) is an emerging biomarker.
- Assessing the prognostic value of RAR in pediatric intensive care unit (PICU) patients is crucial for understanding clinical outcomes.
Purpose of the Study:
- To evaluate the association between the Red Cell Distribution Width-to-Albumin Ratio (RAR) and clinical outcomes in Pediatric Intensive Care Unit (PICU) patients.
- To determine if RAR can predict mortality and other adverse events in critically ill children.
Main Methods:
- Retrospective cohort study utilizing the Pediatric Intensive Care database.
- Inclusion of 7,075 participants with a mean age of 3.4 years.
- Multivariate regression and subgroup analysis to explore the relationship between RAR and patient prognosis.
Main Results:
- Higher RAR levels were significantly associated with increased 28-day mortality (HR=1.06 per unit increase, P=0.015).
- Patients in the high-RAR group (≥4.0) showed substantially higher 28-day mortality compared to the low-RAR group (≤3.36) (HR=1.7, P<0.001).
- Similar associations were found for 90-day and in-hospital mortality rates.
Conclusions:
- The Red Cell Distribution Width-to-Albumin Ratio (RAR) is a significant predictor of adverse outcomes in PICU patients.
- Elevated RAR is associated with increased mortality rates, highlighting its potential as a prognostic marker.
Objective:
This study aimed to assess the association between Red Cell Distribution Width-to-Albumin Ratio (RAR) and the clinical outcomes in Pediatric Intensive Care Unit (PICU) patients.
Design:
This is a retrospective cohort study.
Methods:
We conducted a retrospective cohort study based on the Pediatric Intensive Care database. The primary outcome was the 28-day mortality rate. Secondary outcomes included the 90-day mortality rate, in-hospital mortality rate, and length of hospital stay. We explored the relationship between RAR and the prognosis of patients in the PICU using multivariate regression and subgroup analysis.
Results:
A total of 7,075 participants were included in this study. The mean age of the participants was 3.4 ± 3.8 years. Kaplan-Meier survival curves demonstrated that patients with a higher RAR had a higher mortality rate. After adjusting for potential confounding factors, we found that for each unit increase in RAR, the 28-day mortality rate increased by 6% (HR = 1.06, 95% CI: 1.01-1.11, P = 0.015). The high-RAR group (RAR ≥ 4.0) had a significantly increased 28-day mortality rate compared to the low-RAR group (RAR ≤ 3.36) (HR = 1.7, 95% CI: 1.23-2.37, P < 0.001). Similar results were observed for the 90-day and in-hospital mortality rate. No significant interactions were observed in the subgroup analysis.
Conclusion:
Our study suggests a significant association between RAR and adverse outcomes in PICU patients. A higher RAR is associated with higher 28-day, 90-day, and in-hospital mortality rates.
