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ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1448930
Associations Between Red Cell Distribution Width and In-hospital Mortality in Congestive Heart Failure Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
Provisionally accepted- Second Affiliated Hospital of Jilin University, Changchun, China
Background: Recent studies have identified a co-occurrence of chronic obstructive pulmonary disease and congestive heart failure in ICU patients. Abnormal red cell distribution width (RDW) frequently manifests in critically ill patients, but its clinical significance remains a subject of debate. This study aims to investigate the relationship between RDW and in-hospital mortality in patients with concurrent congestive heart failure and chronic obstructive pulmonary disease.We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care (MIMIC) IV version 2.0 database. RDW levels were assessed within 24 hours of admission. The impact of RDW at ICU admission on in-hospital mortality was analyzed through multivariable logistic regression models, generalized additive models, and subgroup analysis.We enrolled 6,309 patients with congestive heart failure and concomitant chronic obstructive pulmonary disease, with an in-hospital mortality rate of 12.4% (783/6309). The fully adjusted model revealed a positive association between RDW and in-hospital mortality in congestive heart failure patients with concurrent chronic obstructive pulmonary disease, even after accounting for confounding factors (OR = 1.07, 95% CI: 1.03-1.12, p < 0.001). When comparing the highest quartile (Q4) to the lowest quartile (Q1), the odds ratio (OR) was 1.62, with a 95% confidence interval (CI) of 1.17~2.22, p = 0.003. We observed a linear relationship between RDW and inhospital mortality, which remained consistent in subgroup analysis.Our data suggest that RDW is positively associated with in-hospital mortality in patients with both congestive heart failure and chronic obstructive pulmonary disease. At the same time, large prospective research and longer followup time are required to further validate the findings of this study.
Keywords: The study has no Foundation Red cell distribution width, chronic obstructive pulmonary disease, congestive heart failure, In-hospital mortality, Mimic
Received: 07 Jul 2024; Accepted: 13 Feb 2025.
Copyright: © 2025 Zhang, Shi, Cai, Gu, Han, Gu, Zhang, Min, Li and Cui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Kai Zhang, Second Affiliated Hospital of Jilin University, Changchun, China
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