Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis

Abstract Background The association between red blood cell distribution width (RDW) and short- and long-term all-cause mortality in patients with acute pancreatitis (AP) and sepsis remains unclear. Methods Data were extracted from the MIMIC-IV database for patients diagnosed with AP and sepsis. The...

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Main Authors: Qingzhou Song, Xuanlin Wu, Firooz Ahmad Taheri, Linghou Meng, Wentao Wang, Xianwei Mo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04167-5
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author Qingzhou Song
Xuanlin Wu
Firooz Ahmad Taheri
Linghou Meng
Wentao Wang
Xianwei Mo
author_facet Qingzhou Song
Xuanlin Wu
Firooz Ahmad Taheri
Linghou Meng
Wentao Wang
Xianwei Mo
author_sort Qingzhou Song
collection DOAJ
description Abstract Background The association between red blood cell distribution width (RDW) and short- and long-term all-cause mortality in patients with acute pancreatitis (AP) and sepsis remains unclear. Methods Data were extracted from the MIMIC-IV database for patients diagnosed with AP and sepsis. The primary research endpoints were all-cause mortality at 28, 90, and 365 days. Kaplan-Meier survival curve analysis, restricted cubic spline (RCS) receiver operating characteristic (ROC) curves, subgroup analysis, and Cox regression were employed to assess the association between RDW and mortality. Results A total of 759 patients with AP and sepsis were included. The all-cause mortality rates were 17.26%, 25.96%, and 31.49% at 28, 90, and 365 days, respectively. Cox regression analysis indicated that, after adjustment for covariates, elevated RDW was significantly associated with increased risk of mortality at 28, 90, and 365 days. The hazard ratios (HR) were 1.08 (95% CI: 1.02–1.14) for 28-day mortality, 1.12 (95% CI: 1.07–1.17) for 90-day mortality, and 1.13 (95% CI: 1.08–1.18) for 365-day mortality. The RCS analysis indicated a nonlinear relationship. Kaplan-Meier analysis demonstrated significantly higher mortality in the high-RDW group compared to the low-RDW group (p < 0.001). The area under the curve (AUC) for RDW was greater than that for BISAP and SIRS, but lower than the SOFA. Subgroup analyses showed no significant interactions between RDW and most subgroups. Conclusion Elevated RDW is independently associated with increased short- and long-term all-cause mortality in patients with AP and sepsis.
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spelling doaj-art-e7e36f55683b444991d088a51ea351542025-08-20T04:03:06ZengBMCBMC Gastroenterology1471-230X2025-07-0125111410.1186/s12876-025-04167-5Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsisQingzhou Song0Xuanlin Wu1Firooz Ahmad Taheri2Linghou Meng3Wentao Wang4Xianwei Mo5Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer HospitalDepartment of Breast Surgery, Guangxi Medical University Cancer HospitalDivision of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer HospitalDivision of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer HospitalDivision of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer HospitalDivision of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer HospitalAbstract Background The association between red blood cell distribution width (RDW) and short- and long-term all-cause mortality in patients with acute pancreatitis (AP) and sepsis remains unclear. Methods Data were extracted from the MIMIC-IV database for patients diagnosed with AP and sepsis. The primary research endpoints were all-cause mortality at 28, 90, and 365 days. Kaplan-Meier survival curve analysis, restricted cubic spline (RCS) receiver operating characteristic (ROC) curves, subgroup analysis, and Cox regression were employed to assess the association between RDW and mortality. Results A total of 759 patients with AP and sepsis were included. The all-cause mortality rates were 17.26%, 25.96%, and 31.49% at 28, 90, and 365 days, respectively. Cox regression analysis indicated that, after adjustment for covariates, elevated RDW was significantly associated with increased risk of mortality at 28, 90, and 365 days. The hazard ratios (HR) were 1.08 (95% CI: 1.02–1.14) for 28-day mortality, 1.12 (95% CI: 1.07–1.17) for 90-day mortality, and 1.13 (95% CI: 1.08–1.18) for 365-day mortality. The RCS analysis indicated a nonlinear relationship. Kaplan-Meier analysis demonstrated significantly higher mortality in the high-RDW group compared to the low-RDW group (p < 0.001). The area under the curve (AUC) for RDW was greater than that for BISAP and SIRS, but lower than the SOFA. Subgroup analyses showed no significant interactions between RDW and most subgroups. Conclusion Elevated RDW is independently associated with increased short- and long-term all-cause mortality in patients with AP and sepsis.https://doi.org/10.1186/s12876-025-04167-5Red blood cell distribution widthAcute pancreatitisSepsisAll-cause mortalityMIMIC-IV.
spellingShingle Qingzhou Song
Xuanlin Wu
Firooz Ahmad Taheri
Linghou Meng
Wentao Wang
Xianwei Mo
Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
BMC Gastroenterology
Red blood cell distribution width
Acute pancreatitis
Sepsis
All-cause mortality
MIMIC-IV.
title Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
title_full Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
title_fullStr Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
title_full_unstemmed Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
title_short Association of red blood cell distribution width with short- and long-term all-cause mortality in patients with acute pancreatitis and sepsis
title_sort association of red blood cell distribution width with short and long term all cause mortality in patients with acute pancreatitis and sepsis
topic Red blood cell distribution width
Acute pancreatitis
Sepsis
All-cause mortality
MIMIC-IV.
url https://doi.org/10.1186/s12876-025-04167-5
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