Association between Red Blood Cell Distribution Width and Short-Term Mortality in Patients with Paralytic Intestinal Obstruction: Retrospective Data Analysis Based on the MIMIC-III Database

Xuelian Zhao; Xinhuan Wan; Chao Gu; Shanyu Gao; Jiahui Yin; Lizhu Wang; Longfang Quan

doi:10.1155/2023/6739136

Association between Red Blood Cell Distribution Width and Short-Term Mortality in Patients with Paralytic Intestinal Obstruction: Retrospective Data Analysis Based on the MIMIC-III Database

Emerg Med Int. 2023 Oct 23:2023:6739136. doi: 10.1155/2023/6739136. eCollection 2023.

Authors

Xuelian Zhao¹, Xinhuan Wan², Chao Gu³, Shanyu Gao³, Jiahui Yin⁴, Lizhu Wang³, Longfang Quan⁵

Affiliations

¹ The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan 250013, Shandong Province, China.
² School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250013, Shandong Province, China.
³ Department of Anorectal, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China.
⁴ School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250013, Shandong Province, China.
⁵ Department of Anorectal, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing 100091, China.

Abstract

Objective: Elevated red cell distribution (RDW) has been reported to be associated with mortality in patients with acute pancreatitis and cholecystitis admitted to the intensive care unit (ICU). However, evidence for the relationship between RDW and paralytic intestinal obstruction is lacking. Therefore, the article aims to investigate the relationship between RDW and 28-day mortality of the patients with paralytic intestinal obstruction. Patients and Methods. This is a single-center retrospective study. Based on a particular screening criterion, 773 patients with paralytic intestinal obstruction were selected from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Indicators of the first 24 h into the ICU were used to analyze the relationship between RDW and 28-day death from paralytic intestinal obstruction by Kaplan-Meier (K-M) analysis, logistic regression analysis, and stratification analysis.

Results: The curve fitting exhibited a nonlinear relationship. The K-M curve showed that groups with higher RDW values had lower survival rates. The logistic regression analysis revealed that RDW increased with 28-day mortality in patients with paralytic intestinal obstruction in the fully adjusted model. In the fully adjusted model, OR value and 95% CI from the second to the third quantiles compared to the first quartile (reference group) were 1.89 (1.04, 3.44) and 3.29 (1.82, 5.93), respectively. The results of stratified analysis of each layer had the same trend as those of regression analysis, and the interaction results were not significant.

Conclusion: Elevated RDW was associated with increased 28-day mortality from paralytic intestinal obstruction in the ICU. This study can help to further explore the relationship between RDW and death in patients with paralytic intestinal obstruction.