Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units
Objectives Red blood cell distribution width (RDW) with prognosis in various infectious diseases. For fractured patients admitted to the intensive care units (ICU), an accurate and fast appraisal is essential. To investigate the association between RDW and prognosis in fractured patients admitted to...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13614 |
| _version_ | 1797936694285041664 |
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| author | Kaibo Sun Yannan Zhou Yuangang Wu Yi Zeng Jiawen Xu Bin Shen |
| author_facet | Kaibo Sun Yannan Zhou Yuangang Wu Yi Zeng Jiawen Xu Bin Shen |
| author_sort | Kaibo Sun |
| collection | DOAJ |
| description | Objectives Red blood cell distribution width (RDW) with prognosis in various infectious diseases. For fractured patients admitted to the intensive care units (ICU), an accurate and fast appraisal is essential. To investigate the association between RDW and prognosis in fractured patients admitted to the ICU utilizing the MIMIC‐III database. Methods A retrospective cohort from the MIMIC III database from 2001 and 2012 was constructed. RDW and other information were collected with in‐hospital mortality as the primary outcome and 90‐day mortality and hospital and intensive care unit (ICU) length of stay (LOS) as secondary outcomes. Univariate and multivariate logistic regression models with propensity score inverse probability of treatment weighting (IPTW) were used to investigate the prognostic value of RDW. A nomogram was built with significant prognostic factors to predict in‐hospital mortality, and the performance of the nomogram was evaluated and compared with other severity assessment scores. Subgroup analysis was also conducted. Results A total of 2721 fracture patients admitted to the ICU were identified. After IPTW, the group with higher RDW was significantly associated with elevated in‐hospital mortality (odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.19–2.37), 90‐day mortality (OR: 1.39, 95% CI: 1.04–1.86), prolonged hospital LOS (OR: 1.25, 95% CI: 1.03–1.50), and ICU LOS significantly (OR: 1.26, 95% CI: 1.05–1.53) in the multivariate logistics model. The nomogram showed optimal discriminative ability and predictive accuracy with an area under the receiver operating characteristic curve of 0.77. Conclusion RDW independently predicted in‐hospital mortality, 90‐day mortality, and hospital and ICU LOS in fractured patients admitted to ICU. The nomogram including RDW could also be a promising tool with potential clinical benefits. |
| first_indexed | 2024-04-10T18:33:18Z |
| format | Article |
| id | doaj.art-8c98065f8332411a83ff4ab0cb9f99ba |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-10T18:33:18Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-8c98065f8332411a83ff4ab0cb9f99ba2023-02-02T02:44:50ZengWileyOrthopaedic Surgery1757-78531757-78612023-02-0115252553310.1111/os.13614Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care UnitsKaibo Sun0Yannan Zhou1Yuangang Wu2Yi Zeng3Jiawen Xu4Bin Shen5Department of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu ChinaWest China School of Medicine Sichuan University Chengdu ChinaDepartment of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu ChinaDepartment of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu ChinaDepartment of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu ChinaDepartment of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu ChinaObjectives Red blood cell distribution width (RDW) with prognosis in various infectious diseases. For fractured patients admitted to the intensive care units (ICU), an accurate and fast appraisal is essential. To investigate the association between RDW and prognosis in fractured patients admitted to the ICU utilizing the MIMIC‐III database. Methods A retrospective cohort from the MIMIC III database from 2001 and 2012 was constructed. RDW and other information were collected with in‐hospital mortality as the primary outcome and 90‐day mortality and hospital and intensive care unit (ICU) length of stay (LOS) as secondary outcomes. Univariate and multivariate logistic regression models with propensity score inverse probability of treatment weighting (IPTW) were used to investigate the prognostic value of RDW. A nomogram was built with significant prognostic factors to predict in‐hospital mortality, and the performance of the nomogram was evaluated and compared with other severity assessment scores. Subgroup analysis was also conducted. Results A total of 2721 fracture patients admitted to the ICU were identified. After IPTW, the group with higher RDW was significantly associated with elevated in‐hospital mortality (odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.19–2.37), 90‐day mortality (OR: 1.39, 95% CI: 1.04–1.86), prolonged hospital LOS (OR: 1.25, 95% CI: 1.03–1.50), and ICU LOS significantly (OR: 1.26, 95% CI: 1.05–1.53) in the multivariate logistics model. The nomogram showed optimal discriminative ability and predictive accuracy with an area under the receiver operating characteristic curve of 0.77. Conclusion RDW independently predicted in‐hospital mortality, 90‐day mortality, and hospital and ICU LOS in fractured patients admitted to ICU. The nomogram including RDW could also be a promising tool with potential clinical benefits.https://doi.org/10.1111/os.13614Fracture PatientsMortalityPrognosisRed Blood Cell Distribution Width |
| spellingShingle | Kaibo Sun Yannan Zhou Yuangang Wu Yi Zeng Jiawen Xu Bin Shen Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units Orthopaedic Surgery Fracture Patients Mortality Prognosis Red Blood Cell Distribution Width |
| title | Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units |
| title_full | Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units |
| title_fullStr | Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units |
| title_full_unstemmed | Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units |
| title_short | Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units |
| title_sort | elevated red blood cell distribution width is associated with poor prognosis in fractured patients admitted to intensive care units |
| topic | Fracture Patients Mortality Prognosis Red Blood Cell Distribution Width |
| url | https://doi.org/10.1111/os.13614 |
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