Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease
BackgroundThis study aimed to explore the relationship between the blood cell distribution width-to-albumin ratio (RAR) and in-hospital mortality in patients with congestive heart failure (CHF) combined with chronic kidney disease (CKD).MethodsThe patients' information was collected from the Me...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563512/full |
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| author | Lie-jun Qian Lu-xi Hong |
| author_facet | Lie-jun Qian Lu-xi Hong |
| author_sort | Lie-jun Qian |
| collection | DOAJ |
| description | BackgroundThis study aimed to explore the relationship between the blood cell distribution width-to-albumin ratio (RAR) and in-hospital mortality in patients with congestive heart failure (CHF) combined with chronic kidney disease (CKD).MethodsThe patients' information was collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The association of the RAR and in-hospital mortality were assessed via logistic regression analysis with adjusting for different covariate, followed by visualization via the restricted cubic splines (RCS) analysis. Correlation analysis and machine learning algorithms were used to screen the clinical features associated with RAR. Mediation analysis was used to explore the function of RAR-related feature on their association. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) curves were used to explore the efficacy of RAR in predicting patient outcomes and the net clinical benefit, respectively.ResultsA total of 1,243 patients were included in this study. Logistic regression analysis showed that RAR was a risk factor of in-hospital death. RCS showed a linear relationship between RAR and in-hospital mortality, which was not affected by confounding factors. Monocytes played a mediating role in the relationship between RAR and in-hospital mortality. RAR had a good efficacy and clinical net for predicting in-hospital mortality, half-year mortality, one-year mortality, and three-year mortality.ConclusionsWe found that RAR was a risk factor for in-hospital death and could predict short-term and long-term outcomes in patients with CHF combined with CKD. Monocytes played a mediating role in their relationship. |
| format | Article |
| id | doaj-art-034add5249754f6d9d30a9680a9c4cbd |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-034add5249754f6d9d30a9680a9c4cbd2025-08-20T02:44:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.15635121563512Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney diseaseLie-jun Qian0Lu-xi Hong1ICU, Tiantai County Hospital of Traditional Chinese Medicine, Taizhou, Zhejiang, ChinaDepartment of Ultrasound, Tiantai County People’s Hospital, Taizhou, Zhejiang, ChinaBackgroundThis study aimed to explore the relationship between the blood cell distribution width-to-albumin ratio (RAR) and in-hospital mortality in patients with congestive heart failure (CHF) combined with chronic kidney disease (CKD).MethodsThe patients' information was collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The association of the RAR and in-hospital mortality were assessed via logistic regression analysis with adjusting for different covariate, followed by visualization via the restricted cubic splines (RCS) analysis. Correlation analysis and machine learning algorithms were used to screen the clinical features associated with RAR. Mediation analysis was used to explore the function of RAR-related feature on their association. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) curves were used to explore the efficacy of RAR in predicting patient outcomes and the net clinical benefit, respectively.ResultsA total of 1,243 patients were included in this study. Logistic regression analysis showed that RAR was a risk factor of in-hospital death. RCS showed a linear relationship between RAR and in-hospital mortality, which was not affected by confounding factors. Monocytes played a mediating role in the relationship between RAR and in-hospital mortality. RAR had a good efficacy and clinical net for predicting in-hospital mortality, half-year mortality, one-year mortality, and three-year mortality.ConclusionsWe found that RAR was a risk factor for in-hospital death and could predict short-term and long-term outcomes in patients with CHF combined with CKD. Monocytes played a mediating role in their relationship.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563512/fullcongestive heart failure combined with chronic kidney diseaseblood cell distribution width-to-albumin ratioin-hospital mortalitymachine learning algorithmsmediation analysis |
| spellingShingle | Lie-jun Qian Lu-xi Hong Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease Frontiers in Cardiovascular Medicine congestive heart failure combined with chronic kidney disease blood cell distribution width-to-albumin ratio in-hospital mortality machine learning algorithms mediation analysis |
| title | Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| title_full | Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| title_fullStr | Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| title_full_unstemmed | Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| title_short | Association between red blood cell distribution width-to-albumin ratio and in-hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| title_sort | association between red blood cell distribution width to albumin ratio and in hospital mortality in patients with congestive heart failure combined with chronic kidney disease |
| topic | congestive heart failure combined with chronic kidney disease blood cell distribution width-to-albumin ratio in-hospital mortality machine learning algorithms mediation analysis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563512/full |
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