Prognostic ability of the haemoglobin-to-red blood cell distribution width ratio in predicting in-hospital mortality: a retrospective, longitudinal, observational study among elderly patients with acute ischaemic stroke
Objective To evaluate the prognostic ability of the haemoglobin-to-red blood cell distribution width ratio in predicting in-hospital mortality among elderly patients diagnosed with acute ischaemic stroke.Design Retrospective, longitudinal, observational study using a hospital-based database.Setting...
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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e097075.full |
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| Summary: | Objective To evaluate the prognostic ability of the haemoglobin-to-red blood cell distribution width ratio in predicting in-hospital mortality among elderly patients diagnosed with acute ischaemic stroke.Design Retrospective, longitudinal, observational study using a hospital-based database.Setting Claims data from 1 January 2014 until 31 January 2020 were extracted from the database of two hospitals affiliated with Nanjing University.Participants Patients aged ≥80 years who were diagnosed with acute ischaemic stroke, excluding those with cancers or other malignant diseases.Outcome measures Patients were stratified into three groups based on the tertiles of the haemoglobin-to-red blood cell distribution width ratio. The dose-dependent relationship between this ratio and in-hospital mortality risk was determined with robust locally weighted regression analyses and restrictive cubic spline on continuous variables. The primary endpoint was defined as all-cause mortality during the hospital stay, and the secondary endpoint centred on the duration of the hospital stay.Results A total of 606 patients constituted the dataset for the conclusive analysis (mean age, 84.6 ± 3.2 years; female, 40.3%). The haemoglobin-to-red blood cell distribution width ratio was categorised into three tertiles (T1, <6.52; T2, 6.53–8.33; and T3, >8.34). After adjusting for relevant demographic and clinical variables, a statistically significant inverse correlation was observed between higher ratios and lower risk of in-hospital mortality, with HRs of 0.48 (95% CI, 0.34 to 0.68) for T2:T1 and 0.14 (95% CI, 0.08 to 0.23) for T3:T1. A dose-dependent relationship was evident between the haemoglobin-to-red blood cell distribution width ratio and in-hospital mortality risk. The sensitivity analysis indicated that no attenuation was observed in the HR in both non-anaemic and anaemic cases. The results also indicated that a shorter length of hospital stay was associated with a higher haemoglobin-to-red blood cell distribution width ratio.Conclusions A high haemoglobin-to-red blood cell distribution ratio may be an independent protective factor for in-hospital mortality and reduced length of stay in elderly patients suffering from acute ischaemic stroke. |
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| ISSN: | 2044-6055 |