Association of Hemoglobin-to-Red Cell Distribution Width Ratio with Short-Term Mortality in Chronic Critically Ill...

This study aimed to investigate the association between the hemoglobin-to-red cell distribution width ratio (HRR) and 28-day and 90-day all-cause mortality in patients with chronic critical illness (CCI) in the intensive care unit.

We conducted a retrospective analysis of data from 1,541 CCI patients in the Medical Information Mart for Intensive Care IV database. Kaplan-Meier survival curves were used to assess the survival probabilities of patients across different HRR quartiles, and a multivariable Cox regression model was applied to adjust for potential confounding factors and evaluate the relationship between HRR and the risk of mortality.

The analysis revealed a significant inverse association between HRR and both 28-day (hazard ratio [HR] = 0.74, 95% confidence interval [CI] 0.68-0.81, P < 0.001) and 90-day (HR = 0.74, 95% CI 0.69-0.8, P < 0.001) all-cause mortality. In the multivariable Cox regression model, HRR remained significantly associated with a lower risk of mortality even after adjusting for age, gender, and other clinical variables (28-day: HR = 0.84, 95% CI 0.77-0.92, P < 0.001; 90-day: HR = 0.82, 95% CI 0.76-0.89, P < 0.001). HRR quartile analysis showed that compared with Q1, the 28-day mortality risk was reduced by 34%, 27%, and 43% for Q2, Q3, and Q4, respectively, and the 90-day mortality risk was reduced by 32%, 38%, and 49% for Q2, Q3, and Q4, respectively.

HRR is an independent predictor of short-term all-cause mortality in CCI patients and may serve as a useful tool for clinical risk stratification and personalized treatment. This finding provides evidence for the potential value of HRR as a prognostic assessment tool and may have significant implications for clinical decision-making and patient management.