Key points are not available for this paper at this time.
Objective: Heart failure with preserved ejection fraction (HFpEF) in the intensive care unit (ICU) has high mortality, yet reliable bedside prognostic markers remain limited. The red cell distribution width-to-albumin ratio (RDW/Alb), reflecting inflammation and nutrition, has not been validated in this setting. Methods: This retrospective cohort study queried the MIMIC-IV (v2.2) database for adults (≥18 years) with first ICU admission and HFpEF (left ventricular ejection fraction ≥50% by ICD coding or echocardiographic narrative). RDW and serum albumin within 24 h of ICU entry were used to calculate RDW/Alb, analyzed as tertiles (T1 ≤ 4.08; T2 4.08-5.13; T3 > 5.14). The primary endpoint was all-cause mortality at 30, 90, and 365 days. Kaplan-Meier curves, multivariable Cox regression, restricted cubic splines (RCS), and subgroup analyses were conducted. Prognostic discrimination of RDW/Alb was compared with the triglyceride-glucose (TyG) index in a biomarker-complete subset. Findings were externally validated in 429 HFpEF patients from general wards at our hospital. Results: < 0.001). Conclusion: RDW/Alb is a simple, widely available marker that strongly predicts mortality in ICU patients with HFpEF, outperforming TyG and supporting its role in early risk stratification.
Wang et al. (Fri,) studied this question.