Evidence map›Paper›PMID 40790158›Full record

ArticleBMC gastroenterology2025

Association between international normalized ratio-to-albumin ratio and mortality in critically ill patients with gastrointestinal bleeding: a retrospective MIMIC-IV database study.

Xingyi Yang, Shasha Ying, Lihong Lv, Yishu Ji, Jiaqian Ying, Huyan Ke

Abstract read
In one paragraph

Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Relationship Between International Normalized Ratio to Albumin Ratio and Mortality in Critically Ill Patients With Myocardial Infarction.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xingyi YangDepartment of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, 53 Beidong Road, Xianju County, Taizhou, 317300, Zhejiang, China.
Shasha YingDepartment of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, 53 Beidong Road, Xianju County, Taizhou, 317300, Zhejiang, China.
Lihong LvDepartment of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, 53 Beidong Road, Xianju County, Taizhou, 317300, Zhejiang, China.
Yishu JiDepartment of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, 53 Beidong Road, Xianju County, Taizhou, 317300, Zhejiang, China.
Jiaqian YingDepartment of Nursing, Yunnan Technology and Business University, Kunming, China.
Huyan KeDepartment of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, 53 Beidong Road, Xianju County, Taizhou, 317300, Zhejiang, China. 413688532@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile the international normalized ratio-to-albumin ratio (PTAR) is an established independent prognostic indicator for various diseases, its predictive value for clinical outcomes in critically ill patients with acute gastrointestinal bleeding (GIB) has not been systematically evaluated. The present study aims to examine the correlation between PTAR levels and clinical outcomes in critically ill patients with GIB.

methodsTo evaluate mortality risk, we conducted multivariable Cox proportional hazards regression analyses for both short-term and long-term survival, supplemented by Kaplan-Meier (K-M) curve analysis to compare survival trends among subgroups. The discriminatory performance of PTAR was further assessed using receiver operating characteristic (ROC) curve analysis, while restricted cubic splines (RCS) modeled nonlinear associations. Subgroup analyses were performed to examine potential interaction effects, and feature selection was executed via the Boruta algorithm. Finally, a prognostic nomogram integrating the key predictors was developed.

resultsTo explore the prognostic value of PTAR in GIB, this retrospective cohort study analyzed 1,557 patients. X-tile analysis determined an optimal cutoff value of 0.73 for PTAR in predicting 28-day mortality. Subsequent multivariate Cox regression analysis demonstrated that PTAR was an independent predictor of all-cause mortality (P < 0.001). This finding was corroborated by significant differences in KM survival curves (log-rank P < 0.001). Further assessment via ROC analysis indicated that PTAR exhibited moderate prognostic discrimination. Additionally, RCS analysis revealed a linear association between PTAR and mortality (P-nonlinear > 0.05). Subgroup analyses were also performed, yet no significant interactions were observed (all P-interaction values > 0.005). Finally, a nomogram developed using the Boruta algorithm, which incorporated PTAR as a key variable, achieved AUC values of 0.804 for 28-day mortality and 0.791 for 365-day mortality, respectively.

conclusionThe PTAR is significantly associated with increased short- and long-term mortality risk in critically ill patients with GIB.

Indexed as

Critical IllnessGastrointestinal HemorrhageInternational Normalized RatioSerum AlbuminAgedDatabases, FactualFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNomogramsPredictive Value of TestsPrognosisProportional Hazards ModelsRetrospective StudiesSerum AlbuminAll-cause mortalityGastrointestinal bleedingInternational normalized ratioMIMIC-IVPrognosis

Identifiers

PMID40790158
PMCPMC12337426

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.