Assessment of hemoglobin-to-red cell distribution width ratio to predict all-cause mortality in patients with sepsis: a retrospective cohort study from the MIMIC-IV database.

Background: Over the past few years, the Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) has garnered attention as a potential indicator of inflammatory and nutritional status. This study seeks to explore the link between HRR and the prognosis of sepsis patients. Methods: Relying on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, this retrospective cohort study delved into the clinical data of sepsis patients. Through X-tile, patients were categorized into Low-score and High-score groups. Propensity score matching (PSM) analysis was leveraged to control for confounding factors. The main focus was the 28-day mortality of sepsis patients. Kaplan-Meier curves were used to compare survival probabilities across groups. The Cox proportional hazards model and Restricted Cubic Spline were applied to scrutinize the relationship between HRR and 28-day mortality. The predictive capacity of HRR was assessed via ROC curve analysis and subgroup analysis. Results: The study encompassed 28,812 sepsis patients, with 5,697 (19.77%) succumbing to death within 28 days. Post-PSM analysis, the high-score group exhibited a mortality rate of 20.23%, markedly lower than the low-score group's 25.72% ( Conclusion: There's a significant negative correlation between HRR and the 28-day mortality rate of sepsis patients, making HRR an independent prognostic factor. Integrating HRR into existing scoring models can boost predictive accuracy.