ArticlePloS one2025
Relationship between baseline platelet-to-red blood cell distribution width ratio and all-cause mortality in non-traumatic subarachnoid hemorrhage: A retrospective analysis of the MIMIC-IV database.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe study aimed to evaluate the relationship between baseline platelet-to-red blood cell distribution width ratio (PRR) and mortality in critically ill patients with non-traumatic subarachnoid hemorrhage (SAH).
methodsThis cohort study of adults with non-traumatic SAH used Medical Information Mart for Intensive Care (MIMIC-IV) data from 2008-2022 admissions at the Intensive Care Unit (ICU). We collected the PRR levels at admission and determined the all-cause death rates for the ICU and hospital. Cox proportional hazards models were utilized to analyze the association between baseline PRR level and all-cause mortality. Kaplan-Meier survival curve analysis was used to examine the consistency of these correlations. Restricted Cubic Splines (RCS) analysis was used to determine the relationship curve between all-cause mortality and PRR level and examine the threshold saturation effect. To evaluate the consistency of correlations, interaction and subgroup analyses were also conducted.
resultsA total of 1056 patients with non-traumatic SAH were included in this study. All-cause mortalities in the ICU and hospital were 14.8% (156/1056) and 18.6% (196/1056), respectively. Compared to individuals with lower PRR Q1(≤12.67), the adjusted HR values in Q2 (12.68-15.99), Q3 (16.00-19.41), and Q4 (≥19.42) were 0.61 (95%CI:0.40-0.92, p = 0.017), 0.60 (95%CI: 0.39-0.92, p = 0.020), and 0.60 (95% CI:0.39-0.93, p = 0.019), respectively. Kaplan-Meier analysis showed that patients with low PRR levels had significantly higher ICU and in-hospital mortality (p < 0.001). The association between the PRR level and ICU and in-hospital mortality exhibited a non-linear relationship (p < 0.05). The threshold breakpoint value of 22.6 was calculated using RCS analysis. When the PRR level was lower than 22.6, the risk of ICU and in-hospital mortality rates decreased with an HR of 0.91 (95%CI: 0.88-0.94, p < 0.001) and 0.94 (95%CI: 0.92-0.96, p < 0.001), respectively. When the PRR level was higher than 22.6, the risk of ICU mortality (HR = 1.03, 95% CI: 0.97-1.10, p = 0.312) and in-hospital mortality (HR = 1.01, 95%CI: 0.95-1.08, p = 0.693) almost hardly increased with the increase in the PRR level. The interaction between the PRR and all subgroup factors was analyzed, and significant interactions were not observed.
conclusionThere was a non-linear connection between the baseline PRR level and in-hospital mortality. A low level of PRR could increase the risk of death in participants with non-traumatic SAH.
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