Neuropsychiatric Disease and Treatment (Feb 2022)
Relationship Between the Hemoglobin-to-Red Cell Distribution Width Ratio and All-Cause Mortality in Ischemic Stroke Patients with Atrial Fibrillation: An Analysis from the MIMIC-IV Database
Abstract
Zuoan Qin,1,2 Nuohan Liao,3 Xuelin Lu,4 Xiangjie Duan,5 Quan Zhou,6 Liangqing Ge1,2 1Jinan University, Guangzhou, 510632, People’s Republic of China; 2Department of Cardiology, The First People’s Hospital of Changde City, Changde, 415003, People’s Republic of China; 3University of South China, Hengyang, Hunan, 421002, People’s Republic of China; 4Department of Pathology, The First People’s Hospital of Changde City, Changde, 415003, People’s Republic of China; 5Department of Infectious Diseases, The First People’s Hospital of Changde City, Changde, 415003, People’s Republic of China; 6Department of Science and Education, The First People’s Hospital of Changde City, Changde, 415003, People’s Republic of ChinaCorrespondence: Liangqing Ge, Email [email protected]: To investigate the association between the hemoglobin-to-red cell distribution width (RDW) ratio (HRR) and all-cause mortality in ischemic stroke patients with atrial fibrillation (AF).Design: This study was a retrospective cohort analysis. In total, 1018 ischemic stroke patients with AF were enrolled using the Medical Information Mart for Intensive Care database, (MIMIC)-IV. The patients were divided into four groups according to the HRR values. The primary outcome was 180-day all-cause mortality.Methods: Multivariate Cox proportional risk regression models were used to examine the association between HRR and all-cause mortality. The non-linear relationship between HRR and all-cause mortality was confirmed using a Cox proportional risk regression model fitted by cubic spline function and smooth curve fitting.Results: A total of 246/1018 patients (24.17%) died. The serum HRR values were negatively associated with 180-day all-cause mortality (hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.68– 0.94). A two-piecewise regression model was used to obtain a threshold inflection point value of 9.74. The HR and the 95% CI on the left inflection point were 0.73 and 0.61– 0.87 (p = 0.0005); on the right inflection point they were 1.06 and 0.82– 1.38 (p = 0.6383).Conclusion: The relationship between all-cause mortality and the HRR values was non-linear in ischemic stroke patients with AF. All-cause mortality and HRR values were negatively correlated when the HRR value was ≤ 9.74.Keywords: ischemic stroke, atrial fibrillation, all-cause mortality, MIMIC-IV
