Abstract
BACKGROUND: As red blood cell distribution width (RDW) and albumin have been shown to be independent predictors of mortality from various diseases, this study aimed to investigate the effect of the RDW to albumin ratio (RA) as an independent predictor of the prognosis of patients admitted to the coronary care unit (CCU). AIM: To use the RDW and albumin level to predict the prognosis of patients in the CCU. METHODS: Data were obtained from the Medical Information Mart Intensive Care III database. The primary outcome was 365-day all-cause mortality, whereas the secondary outcomes were 30- and 90-day all-cause mortality, hospital length of stay (LOS), and CCU LOS. Cox proportional hazards regression model, propensity score matching, and receiver operating characteristic curve analyses were used. RESULTS: The hazard ratio (95% confidence interval) of the upper tertile (RA > 4.66) was 1.62 (1.29 to 2.03) when compared with the reference (RA < 3.84) in 365-day all-cause mortality. This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis. Similar trends were observed for the secondary outcomes of hospital and CCU LOS. Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment (SOFA) scores, and the C-statistic was higher than that of the SOFA scores (0.733 vs 0.702, P < 0.001). CONCLUSION: RA is an independent prognostic factor in patients admitted to the CCU. RA combined with the SOFA score can improve the predictive ability of the SOFA score. However, our results should be verified in future prospective studies.