Background Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery. Methods Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan-Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs. Results The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P&0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio=1.17, 95% confidence interval, 1.10-1.25). Our ROC results showed the predictive value of the RDW. Conclusions An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.

中文翻译：

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接受心脏手术的重症监护患者红细胞分布宽度与 30 天死亡率之间的关联：基于重症监护医疗信息集市 IV 数据库的回顾性观察研究。


背景 每年有数百万患者接受心脏手术。红细胞分布宽度（RDW）可以帮助预测接受经皮冠状动脉介入治疗或冠状动脉搭桥手术的患者的预后。我们研究了 RDW 对重症监护病房 (ICU) 患者接受心脏手术后 30 天的死亡率是否具有可靠的预测价值。方法 使用重症监护医疗信息集市 IV 数据库，我们检索了 11,634 名在 ICU 接受心脏手术的患者的数据。我们进行了多变量 Cox 回归分析来模拟 RDW 和 30 天死亡率之间的关联，并绘制了 Kaplan-Meier 曲线。使用相关协变量对亚组分析进行分层。受试者工作特征 (ROC) 曲线用于确定 RDW 的预测值。结果 30天总死亡率为4.2%（485/11,502）。 RDW升高组的30天死亡率高于RDW正常组（P&0.001）。我们的数据分析的稳健性通过进行亚组分析得到了证实。当 RDW 用作连续变量时，RDW 每增加一个单位，与 30 天死亡率增加 17% 相关（调整后的风险比 = 1.17，95% 置信区间，1.10-1.25）。我们的 ROC 结果显示了 RDW 的预测价值。结论 RDW 升高与在 ICU 环境中接受心脏手术的患者较高的 30 天死亡率相关。 RDW 可以作为一种有效且易于使用的方法来预测 ICU 患者心脏手术后的死亡率。