Association between red cell distribution width and all-cause mortality in patients with breast cancer: A retrospective analysis using MIMIC-IV 2.0

• Published in: PloS one 2024-05, Vol.19 (5), p.e0302414-e0302414
• Main Authors: Xiao, Jie, Tan, Libi, Pei, Yujie, Yang, Ruifang, Li, Jing, Feng, Yong, Feng, Jing
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Analysis; Biology and Life Sciences; Blood; Blood cell count; Body mass index; Breast cancer; Breast Neoplasms - blood; Breast Neoplasms - mortality; Breast surgery; Cardiovascular disease; Confidence intervals; Erythrocyte Indices; Erythrocytes; Fatalities; Female; Hazards; Health aspects; Heart attacks; Heart failure; Hemoglobin; Hospital Mortality; Humans; Intensive care; Kidney diseases; Liver diseases; Medical prognosis; Medical research; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; Mortality; Normal distribution; Patient outcomes; Patients; Prognosis; Proportional Hazards Models; Quartiles; Radiation; Regression analysis; Retrospective Studies; Rheumatic diseases; Risk Factors; Statistical analysis; Subgroups; Survival analysis; Variables; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0302414

Investigating the association between red cell distribution width (RDW) and all-cause mortality in patients with breast cancer, to evaluate the potential clinical prognostic value of RDW. Based on the RDW index, patients with breast cancer in the Medical Information Mart for Intensive Care (MIMIC-IV) database were categorized into quartiles. The primary outcomes included in-hospital mortality from all causes during the first six months, the first year, and the first three years. Cox hazards regression and restricted cubic spline (RCS) models were developed to investigate the effects of RDW on primary outcomes. The study included 939 patients (female). The 6-month, 1-year, and 3-year mortality rates were 14.0%, 21.4%, and 28.4%, respectively. Multivariate Cox proportional hazards analyses demonstrated that RDW exhibited an autonomous association with an increased risk of all-cause mortality. After adjusting for confounders, higher RDW quartiles were significantly associated with 6-month mortality (adjusted hazard ratio (HR), 3.197; 95% confidence interval (CI), 1.745-5.762; P < 0.001), 1-year mortality (adjusted HR, 2.978; 95% CI, 1.867-4.748; P < 0.001), and 3-year mortality (adjusted HR, 2.526; 95% CI, 1.701-3.750; P < 0.001). The RCS curves demonstrated that high RDW (> 14.6) was associated with a greater risk of all-cause mortality. Subgroup analyses revealed no statistically significant differences in the interactions between the subgroups. The study revealed a highly pronounced relationship between RDW and overall mortality, indicating its potential as an autonomous prognostic factor for increased mortality among patients with breast cancer.