Work

Prognostic value of RDW-to-platelet ratio for short- and long-term mortality after cardiac surgery: dual-center MIMIC-IV and external validation

Year: 2026

Type: article

Abstract: The prognostic value of red cell distribution width to platelet ratio (RPR) in cardiac surgery remains unclear. This retrospective study included 8,619 patients from MIMIC-IV and 2,730 from an external cohort. RPR tertiles were used to assess associations with 28‑ and 365‑day mortality using Cox and restricted cubic spline (RCS) analyses. In MIMIC-IV, the highest RPR tertile (T3, ≥ 0.11) was associated with significantly increased mortality risk compared to the middle tertile. Fully adjusted hazard ratios for T3 were 2.168 (95% CI 1.300–3.614) for 28-day mortality and 1.575 (95% CI 1.111–2.233) for 365-day mortality. RCS revealed a nonlinear U-shaped relationship (P for nonlinear < 0.001 and = 0.001, respectively). Subgroup effects were more pronounced in females, hypertensive patients, and those without diabetes, heart failure, or COPD (P for interaction < 0.05). These findings were validated in the external cohort, which showed similar effect magnitudes and nonlinear patterns (P for nonlinear = 0.001 for 28-day; = 0.003 for 365-day mortality). Kaplan–Meier analysis confirmed significant mortality differences across RPR tertiles in both cohorts. RPR is independently and nonlinearly associated with increased short- and long-term mortality after cardiac surgery, suggesting its utility in perioperative risk stratification.

Source: Scientific Reports

DOI: 10.1038/s41598-026-76834-w

Authors: Qiannan Guo, Yuehang Yang, Hanshen Luo, Chuli Shi, Jiawei Shi

Institutions: Wuhan Union Hospital, Huazhong University of Science and Technology

Language: English

Topic: Inflammatory Biomarkers in Disease Prognosis

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,690