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Updated: Apr 19, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
The association between RDW-to-platelet ratio and in-hospital mortality in critically ill stroke patients: A
Yu Chen1, Xiangrong Yang1, Minmin Lan1
1Department of Neurology, Guangxi Hydroelectric Hospital, Guilin, Guangxi, China.
Objective:
The red cell distribution width-to-platelet ratio (RDW-to-platelet ratio, RPR) is a potential biomarker of inflammation and bone marrow function. This study aimed to investigate the association between RPR and in-hospital mortality in critically ill stroke patients in the eICU, and to evaluate mediating role of APACHE-IV score.
Method:
This retrospective cohort study utilized data from the 2014-2015 US multicenter eICU database. Of 200,859 initially included patients, 9,736 critically ill stroke patients were analyzed after excluding non-stroke cases and those with missing key variables. Multivariable logistic regression assessed the relationship between RPR and in-hospital mortality, adjusting for age, sex, comorbidities, and laboratory parameters, with multiple imputation for missing data. Subgroup analyses, mediation analysis, and restricted cubic spline modeling were performed.
Results:
Patients with higher RPR exhibited significantly elevated in-hospital mortality (17.7% vs. 11.6%, P < 0.001). After adjustment, each unit increase in RPR was associated with 4.6% higher odds of death (adjusted OR=1.046, 95% CI: 1.032-1.061, P < 0.001), with consistent findings across subgroups. Restricted cubic spline analysis indicated a linear relationship. Mediation analysis showed that APACHE-IV score mediated 20.15% of the total effect (P < 0.001).
Conclusions:
Elevated RPR is independently associated in-hospital mortality in critically ill stroke patients, partly mediated by disease severity. As a simple and accessible marker, RPR shows promise for clinical prognostic risk stratification.