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June 6, 2026Open Access

Prognostic value of the hemoglobin-to-red cell distribution width ratio (HRR) in predicting mortality and rehospitalization in patients with chronic heart failure

Key Points

This study evaluates the prognostic value of the hemoglobin-to-red cell distribution width ratio (HRR) in predicting mortality and rehospitalization in patients with chronic heart failure.
Included 419 patients with chronic heart failure for analysis.
Evaluated the relationship between HRR and all-cause mortality and rehospitalization over 12 months.
Lower HRR was associated with increased all-cause mortality (Adjusted OR: 0.83; 95% CI: 0.73-0.95; p = 0.006).
Higher HRR was linked to reduced rehospitalization odds in non-anemic patients (Adjusted OR: 0.81; 95% CI: 0.66-0.99; p < 0.05).

Abstract

OBJECTIVE: Heart failure (HF) represents a significant and growing global health burden. The hemoglobin-to-red cell distribution width ratio (HRR), a novel composite marker integrating oxygen-carrying capacity (hemoglobin) and red cell distribution width (RDW), has shown prognostic value in various diseases, but its role in chronic HF remains underexplored. This study aimed to evaluate the prognostic value of HRR for mortality and 12-month rehospitalization in patients with chronic HF. RESULTS: A total of 419 patients with chronic heart failure were included in the analysis. A lower HRR was independently associated with increased all-cause mortality. Each unit increase in HRR was associated with a 17% reduction in mortality odds (Adjusted OR: 0.83; 95% CI: 0.73-0.95; p = 0.006). This inverse relationship was significant in anemic patients but not in non-anemic patients. In contrast, HRR was not associated with rehospitalization in the overall or anemic populations, but a higher HRR was significantly associated with reduced rehospitalization odds in non-anemic patients (Adjusted OR: 0.81; 95% CI: 0.66-0.99; p < 0.05).

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