AUTHOR=Liang Hanbai , Liu Ping , Guo Lei , Feng Jie , Yin Cheng , Zhao Dongdong , Chen Longyi 

TITLE=Predictive value of admission red cell distribution width-to-platelet ratio for 30-day death in patients with spontaneous intracerebral hemorrhage: an analysis of the MIMIC database

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1221335

DOI=10.3389/fneur.2023.1221335

ISSN=1664-2295

ABSTRACT=Aim: Prognostic assessment plays an important role in the effective management of patients with spontaneous intracerebral hemorrhage (ICH). To investigate whether elevated red cell distribution width to platelet ratio (RPR) at admission was related to 30-day death in patients with spontaneous intracerebral hemorrhage (ICH). 
Methods: This retrospective cohort study included 2,823 adult patients with ICH from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) Ⅲ and Ⅳ databases between 2001 and 2019. Cox proportional hazard model was utilized to evaluate the relationship between RPR levels and 30-day death risk. The area under receiver-operating characteristic curve (AUC) was used to assess the predictive ability of RPR for 30-day death in patients with ICH. 
Results: At the end of 30-day follow-up, 799 (28.30%) patients died and the median RPR level was 0.066 (0.053, 0.087). After adjusting for confounders, the tertile 3 of RPR levels [hazard ratio (HR)=1.37, 95% confidence interval (CI): 1.15-1.64] were associated with higher risk of 30-day death in patients with ICH compared with tertile 1. In the stratified analyses, elevated RPR levels were found to be associated with an increased risk of 30-day death in patients aged <65 years (HR=1.77, 95%CI: 1.29-2.43), aged ≥65 years (HR=1.30, 95%CI: 1.05-1.61), with Glasgow Coma Score (GCS) score <14 (HR=1.65, 95%CI: 1.27-2.14), with Charlson comorbidity index (CCI) ≥4 (HR=1.45, 95%CI: 1.17-1.80), with (HR=1.66, 95%CI: 1.13-2.43) or without sepsis (HR=1.32, 95%CI: 1.08-1.61), and females (HR=1.75, 95%CI: 1.35-2.26), but not in males (P=0.139) and patients with GCS ≥14 (P=0.058) or CCI <4 (P=0.188). The AUC for RPR to predict 30-day death in patients with ICH was 0.795 (95%CI: 0.763-0.828) in the testing set, indicating a good predictive ability. 
Conclusion: Elevated RPR levels were correlated with an increased risk of 30-day death in patients with ICH, and RPP levels showed good predictive ability for 30-day death.