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Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: Results from the cohort study of NHANES, 1999–2018

Year: 2025
Type: article
Abstract: OBJECTIVES: To investigate the association of red blood cell distribution width (RDW) to albumin ratio (RAR) with mortality in chronic obstructive pulmonary disease (COPD) patients. METHODS: We selected 1,652 patients with COPD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, who were categorized into four groups according to the RAR quartiles. Kaplan-Meier curves, restricted cubic splines and the Cox proportional hazard model were used to evaluate the associations between RAR and all-cause mortality and chronic lower respiratory disease (CLRD) mortality in the COPD patients. Subgroup analyses were performed to check the interaction of the different characteristics. RESULTS: There were 640 deaths during follow-up, of which, 145 were from CLRD. Kaplan-Meier curves indicated COPD patients with higher RAR had significantly increased all-cause mortality and CLRD mortality. Multivariate Cox regression analyses showed HR of Q4 RAR was 2.88 (95% CI 2.18 - 3.81, p < 0.0001) for all cause-mortality and 3.39 (95% CI 1.76 - 6.53, p < 0.001) for CLRD mortality, compared with Q1 RAR. Restricted cubic splines analysis indicated a dose-response between RAR and risk of all-cause and CLRD mortality (p for non-linearity < 0.001). CONCLUSION: RAR had an independent association with all-cause mortality, especially CLRD mortality, in COPD patients. RAR has potential as a novel and promising predictor to identify COPD individuals with high mortality risk.
Source: PLoS ONE
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W4409049610
FWCI: 1.76
Cites: 56
Cited by: 3
Related to: 10