ArticleThe Journal of international medical research2026
Association between hemoglobin-to-red blood cell distribution width ratio and 28-day all-cause mortality in patients with acute kidney injury: A cross-sectional study.
Article in The Journal of international medical research, 2026. 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
BackgroundThe prognostic significance of the hemoglobin-to-red blood cell distribution width ratio (HRR) for 28-day all-cause mortality remains incompletely characterized in patients with acute kidney injury.MethodsThis cross-sectional study included 27,670 patients with acute kidney injury from the Medical Information Mart for Intensive Care-IV database (2008-2022). Multivariable Cox regression, Kaplan-Meier survival analysis, and receiver operating characteristic curve analysis were performed.ResultsPatients were stratified by HRR tertiles: T1 (1.84-6.4), T2 (6.4-8.37), and T3 (8.37-15.5). Mortality rates differed significantly across tertiles (25.2% vs. 14% vs. 8.9%, p < 0.001). Kaplan-Meier analysis showed a significantly higher mortality risk in the lower HRR tertiles (log-rank p < 0.0001). After full adjustment for potential confounders, the hazard ratios were 0.68 (95% confidence interval: 0.63-0.74) for T2 and 0.58 (95% confidence interval: 0.52-0.65) for T3, compared with T1. Receiver operating characteristic curve analysis identified an optimal HRR cutoff value of 6.53 (area under the curve: 0.657, 95% confidence interval: 0.648-0.666) for risk stratification.ConclusionLower HRR values were independently associated with an increased risk of 28-day mortality in critically ill patients, with a practical cutoff of 6.53 for clinical application.
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