The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis
Abstract Background Red blood cell distribution width (RDW), a marker of erythrocyte size variability, has been associated with adverse outcomes in various inflammatory and critical illnesses, but the impact on long-term outcomes in critically ill patients remains unclear. We hence aimed to address...
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2025-07-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02839-2 |
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| author | Shang-Yi Lee Li-Ting Wong Wen-Cheng Chao |
| author_facet | Shang-Yi Lee Li-Ting Wong Wen-Cheng Chao |
| author_sort | Shang-Yi Lee |
| collection | DOAJ |
| description | Abstract Background Red blood cell distribution width (RDW), a marker of erythrocyte size variability, has been associated with adverse outcomes in various inflammatory and critical illnesses, but the impact on long-term outcomes in critically ill patients remains unclear. We hence aimed to address the association between RDW and one-year mortality in critically ill patients through using a propensity score-based analysis. Methods The data from three databases were aggregated: the Medical Information Mart for Intensive Care IV (MIMIC-IV), the Salzburg Intensive Care database (SICdb), and the Taichung Veterans General Hospital (TCVGH) critical care database. Cox regression, propensity score matching (PSM), and weighting methods consisting of inverse probability of treatment weighting (IPTW), stabilized IPTW, as well as covariate balancing propensity score (CBPS) were used to identify the independent association between RDW and one-year mortality. Results A total of 39,699 critically ill patients were included in the analysis, with a one-year mortality rate of 27.3%. High RDW was significantly associated with increased one-year mortality (adjusted hazard ratio 1.980, 95% confidence interval (CI) 1.898–2.066, p < 0.001) after adjusting for covariates. The association was stronger among patients with milder forms of critical illnesses. The association between high RDW and mortality in PSM, IPTW, stabilized IPTW and CBPS populations were 1.751 (95% CI 1.627–1.885), 1.960 (95% CI 1.873–2.051), 1.962 (95% CI 1.875–2.052) and 1.946 (95% CI 1.845–2.053). Conclusion Week-one RDW is a robust predictor of one-year mortality in critically ill patients. Our data suggest that RDW may serve as a prognostic tool for early risk stratification of long-term outcomes in critical care. |
| format | Article |
| id | doaj-art-1182d4cac26f42e9ac0f2cdd4e5153c0 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | European Journal of Medical Research |
| spelling | doaj-art-1182d4cac26f42e9ac0f2cdd4e5153c02025-08-20T04:01:25ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111110.1186/s40001-025-02839-2The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysisShang-Yi Lee0Li-Ting Wong1Wen-Cheng Chao2Department of Anesthesiology, Taichung Veterans General Hospital Puli BranchDepartment of Medical Research, Taichung Veterans General HospitalDepartment of Critical Care Medicine, Taichung Veterans General HospitalAbstract Background Red blood cell distribution width (RDW), a marker of erythrocyte size variability, has been associated with adverse outcomes in various inflammatory and critical illnesses, but the impact on long-term outcomes in critically ill patients remains unclear. We hence aimed to address the association between RDW and one-year mortality in critically ill patients through using a propensity score-based analysis. Methods The data from three databases were aggregated: the Medical Information Mart for Intensive Care IV (MIMIC-IV), the Salzburg Intensive Care database (SICdb), and the Taichung Veterans General Hospital (TCVGH) critical care database. Cox regression, propensity score matching (PSM), and weighting methods consisting of inverse probability of treatment weighting (IPTW), stabilized IPTW, as well as covariate balancing propensity score (CBPS) were used to identify the independent association between RDW and one-year mortality. Results A total of 39,699 critically ill patients were included in the analysis, with a one-year mortality rate of 27.3%. High RDW was significantly associated with increased one-year mortality (adjusted hazard ratio 1.980, 95% confidence interval (CI) 1.898–2.066, p < 0.001) after adjusting for covariates. The association was stronger among patients with milder forms of critical illnesses. The association between high RDW and mortality in PSM, IPTW, stabilized IPTW and CBPS populations were 1.751 (95% CI 1.627–1.885), 1.960 (95% CI 1.873–2.051), 1.962 (95% CI 1.875–2.052) and 1.946 (95% CI 1.845–2.053). Conclusion Week-one RDW is a robust predictor of one-year mortality in critically ill patients. Our data suggest that RDW may serve as a prognostic tool for early risk stratification of long-term outcomes in critical care.https://doi.org/10.1186/s40001-025-02839-2RDWCritical careDatabaseLong-term mortalityPropensity score |
| spellingShingle | Shang-Yi Lee Li-Ting Wong Wen-Cheng Chao The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis European Journal of Medical Research RDW Critical care Database Long-term mortality Propensity score |
| title | The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis |
| title_full | The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis |
| title_fullStr | The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis |
| title_full_unstemmed | The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis |
| title_short | The association between week-one red blood cell distribution width and one-year survival in critically ill patients: propensity score-based multicenter analysis |
| title_sort | association between week one red blood cell distribution width and one year survival in critically ill patients propensity score based multicenter analysis |
| topic | RDW Critical care Database Long-term mortality Propensity score |
| url | https://doi.org/10.1186/s40001-025-02839-2 |
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