Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.

<h4>Objectives</h4>To investigate the association of red blood cell distribution width (RDW) to albumin ratio (RAR) with mortality in chronic obstructive pulmonary disease (COPD) patients.<h4>Methods</h4>We selected 1,652 patients with COPD from the National Health and Nutrit...

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Main Authors: Guoxin Zhang, Beizheng Xu, Xiaoyun Zhao
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0319869
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author Guoxin Zhang
Beizheng Xu
Xiaoyun Zhao
author_facet Guoxin Zhang
Beizheng Xu
Xiaoyun Zhao
author_sort Guoxin Zhang
collection DOAJ
description <h4>Objectives</h4>To investigate the association of red blood cell distribution width (RDW) to albumin ratio (RAR) with mortality in chronic obstructive pulmonary disease (COPD) patients.<h4>Methods</h4>We selected 1,652 patients with COPD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, who were categorized into four groups according to the RAR quartiles. Kaplan-Meier curves, restricted cubic splines and the Cox proportional hazard model were used to evaluate the associations between RAR and all-cause mortality and chronic lower respiratory disease (CLRD) mortality in the COPD patients. Subgroup analyses were performed to check the interaction of the different characteristics.<h4>Results</h4>There were 640 deaths during follow-up, of which, 145 were from CLRD. Kaplan-Meier curves indicated COPD patients with higher RAR had significantly increased all-cause mortality and CLRD mortality. Multivariate Cox regression analyses showed HR of Q4 RAR was 2.88 (95% CI 2.18 - 3.81, p < 0.0001) for all cause-mortality and 3.39 (95% CI 1.76 - 6.53, p < 0.001) for CLRD mortality, compared with Q1 RAR. Restricted cubic splines analysis indicated a dose-response between RAR and risk of all-cause and CLRD mortality (p for non-linearity < 0.001).<h4>Conclusion</h4>RAR had an independent association with all-cause mortality, especially CLRD mortality, in COPD patients. RAR has potential as a novel and promising predictor to identify COPD individuals with high mortality risk.
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spelling doaj-art-c2fb187d87624ff688bbbc2cad1d1ccb2025-08-20T02:08:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01204e031986910.1371/journal.pone.0319869Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.Guoxin ZhangBeizheng XuXiaoyun Zhao<h4>Objectives</h4>To investigate the association of red blood cell distribution width (RDW) to albumin ratio (RAR) with mortality in chronic obstructive pulmonary disease (COPD) patients.<h4>Methods</h4>We selected 1,652 patients with COPD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, who were categorized into four groups according to the RAR quartiles. Kaplan-Meier curves, restricted cubic splines and the Cox proportional hazard model were used to evaluate the associations between RAR and all-cause mortality and chronic lower respiratory disease (CLRD) mortality in the COPD patients. Subgroup analyses were performed to check the interaction of the different characteristics.<h4>Results</h4>There were 640 deaths during follow-up, of which, 145 were from CLRD. Kaplan-Meier curves indicated COPD patients with higher RAR had significantly increased all-cause mortality and CLRD mortality. Multivariate Cox regression analyses showed HR of Q4 RAR was 2.88 (95% CI 2.18 - 3.81, p < 0.0001) for all cause-mortality and 3.39 (95% CI 1.76 - 6.53, p < 0.001) for CLRD mortality, compared with Q1 RAR. Restricted cubic splines analysis indicated a dose-response between RAR and risk of all-cause and CLRD mortality (p for non-linearity < 0.001).<h4>Conclusion</h4>RAR had an independent association with all-cause mortality, especially CLRD mortality, in COPD patients. RAR has potential as a novel and promising predictor to identify COPD individuals with high mortality risk.https://doi.org/10.1371/journal.pone.0319869
spellingShingle Guoxin Zhang
Beizheng Xu
Xiaoyun Zhao
Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
PLoS ONE
title Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
title_full Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
title_fullStr Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
title_full_unstemmed Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
title_short Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999-2018.
title_sort red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients results from the cohort study of nhanes 1999 2018
url https://doi.org/10.1371/journal.pone.0319869
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