ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurotrauma
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1534098
The association between hemoglobin-to-red blood cell distribution width ratio ratio and 28-day mortality in Epidural Hemorrhage: a cohort study
Provisionally accepted
- 1Department of Neurosurgery, First People's Hospital of Kunshan, Suzhou, Jiangsu Province, China
- 2Kunshan Affiliated Hospital, Nanjing University of Chinese Medicine, Suzhou, China
- 3The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: This study leverages the eICU collaborative research database (eICU-CRD) to investigate the relationship between the hemoglobin-to-red blood cell distribution width ratio (HRR) and 28-day mortality in patients with epidural hematoma(EDH).Methods: 2,161 patients admitted between 2014 and 2015 with EDH were selected. Data included demographics, medical history, and laboratory tests. HRR was calculated and stratified into quartiles.Covariates included glasgow coma scale (GCS), HDL, TG, hospital time, ICU time, LDL, age, BMI, gender, coma status, race, and medical conditions like COPD, CHF, and diabetes. Non-normal data distributions were analyzed using Kruskal-Wallis and chi-square tests, with logistic regression to explore the association of HRR and 28-day mortality.Results: Higher HRR quartiles correlated with lower 28-day mortality (P=0.024) and higher healthy discharge rates (P=0.013). Univariate logistic analysis showed age positively associated with mortality (OR=1.011, 95%CI: 1.004-1.018), while GCS, ICU time, hospital time, and HRR were negatively associated. Adjusted models confirmed an inverse relationship between HRR and mortality, with the fourth quartile showing a 40% reduced probability of mortality. Linear regression models indicated a 72% reduction in mortality risk per unit HRR increase and a critical HRR value of 1.12 for significant risk reduction.HRR is significantly associated with 28-day mortality in EDH patients, with higher HRR values correlating with improved survival. ICU time also showed a correlation with reduced mortality, particularly up to a critical point.
Keywords: Epidural hematoma, Hemoglobin-to-red blood cell distribution width ratio, 28-day mortality, ICU, eICU-CRD
Received: 25 Nov 2024; Accepted: 19 Jun 2025.
Copyright: © 2025 Liu, wang, wang, Ruan and liu. 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: Jiangang liu, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.