The Red Blood Cell Distribution Width–Albumin Ratio: A Promising Predictor of Mortality in Stroke Patients

OBJECTIVE: Within this study we attempt to express a correlation between the mortality of stroke and stroke related infection to a novel biomarker represented by the red blood cell width-albumin levels ratio within the patient. We hypothesize that this novel biomarker could be utilized as better predictive tool for stroke associated infections. METHODS: Patient data sets were obtained via the Medical Information Mart for Intensive Care Database iii V1.4 (MIMIC-iii). Data from 1480 patients were obtained to serve the testing for the RA biomarker tests. Clinical endpoints of 30-, 60-, and 365-day all-cause mortality in stroke patients were used as subgroups within the analyzed population. Estimation of hazard ratios (HR) were obtained from Cox regression models for stroke-associated infection and all-cause mortality in relation to RA values. RESULTS: A high-RA was associated with increased mortality in ICU patients suffering from a stroke. After adjusting for age and sex, compared to the reference group (the first quartile), the high-RA group had the highest 30-day (HR, 95% CI: 1.88 (1.36, 2.58)), 90-day (HR, 95% CI: 2.12 (1.59, 2.82)), and one-year (HR, 95% CI: 2.15 (1.65, 2.80)) all-cause mortality. The RA values were independently associated with an increased risk of stroke-associated infection when adjusting for confounders. CONCLUSIONS: Our data suggest RA may be an easily accessible, reproducible, and low-cost biomarker for predicting stroke-associated infections and mortality in patients who have suffered from a stroke.