The Red Blood Cell Distribution Width–Albumin Ratio Was a Potential Prognostic Biomarker for Diabetic Ketoacidosis

Figures & data

Table 1 Characteristics of Enrolled Patients

Characteristics	Low Group^a	High Group^b	P-value
N	187	188
Age	42.7 ± 15.6	51.8 ± 17.3	<0.001
Gender, n (%)			0.491
Male	112 (59.9)	106 (56.4)
Female	75 (40.1)	82 (43.6)
Vital signs
Heart rate, beats/minute	95.1 ± 14.4	91.9 ± 16.4	0.046
Respiratory rate, breaths/minute	18.8 ± 3.5	19.9 ± 4.4	0.008
SBP, mmHg	123.7 ± 18.8	123.7 ± 18.2	0.999
DBP, mmHg	65.3 ± 12.6	62.1 ± 11.1	0.009
SPO2, %	98.2 ± 1.4	97.9 ± 1.7	0.158
Temperature, °C	36.9 ± 0.4	36.8 ± 0.7	0.082
Comorbidities, n (%)
Congestive heart failure	16 (8.6)	40 (21.3)	<0.001
Valvular disease	1 (0.5)	9 (4.8)	0.011
Renal failure	21 (11.2)	59 (31.4)	<0.001
Chronic pulmonary disease	22 (11.8)	29 (15.4)	0.301
Hypothyroidism	90 (48.1)	109 (58.0)	0.056
Liver disease	15 (8.0)	16 (8.5)	0.863
Sepsis	3 (1.6)	21 (11.2)	<0.001
Septic shock	3 (1.6)	15 (8.0)	0.004
Laboratory parameters
Lactate, mmol/L	2.0 ± 1.2	1.8 ± 1.0	0.193
White blood cell, ×10^9/L	14.2 ± 6.7	14.0 ± 7.7	0.808
Albumin, g/L	4.2 ± 0.6	3.1 ± 0.4	<0.001
90-Day all-cause mortality, n (%)	2 (1.1)	15 (8.0)	0.001
365-Day all-cause mortality, n (%)	5 (2.7)	33 (17.6)	<0.001
SAPSII	27.8 ± 10.7	35.3 ± 13.3	<0.001
SOFA	2.8 ± 1.9	4.5 ± 3.1	<0.001

Notes: ^{a, b}RA < 3.89 was regarded as the low group, RA > 3.89 was considered as the high group.

Abbreviations: RA, red blood cell distribution width–albumin ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure; SPO₂, oxygen saturation; SAPSII, The Simplified Acute Physiology Score II; SOFA, Sequential Organ Failure Assessment.

Table 2 Association Between RA and Mortality of DKA

	Non-Adjusted^a			Model 1^b			Model 2^c
	HR (95% CIs)	P value	P for Trend	HR (95% CIs)	P value	P for Trend	HR (95% CIs)	P value	P for Trend
90-Day all-cause mortality	2.1 (1.5, 3.0)	<0.001		1.8 (1.3, 2.6)	<0.001		2.2 (1.4, 3.6)	<0.001
Seconde
2.28–3.88	Reference			Reference			Reference
3.89–10.25	7.8 (1.8, 34.0)	0.006		4.9 (1.1, 22.1)	0.038		5.5 (1.2, 26.4)	0.032
Group trend	5.5 (1.6, 19.0)		0.006	3.8 (1.1, 13.2)		0.038	4.2 (1.1, 15.3)		0.032
365-Day all-cause mortality	1.9 (1.5, 2.5)	<0.001		1.6 (1.3, 2.1)	<0.001		1.6 (1.2, 2.1)	<0.001
Seconde
2.28–3.88	Reference			Reference			Reference
3.89–10.25	7.2 (2.8, 18.4)	<0.001		4.4 (1.7, 11.4)	0.003		4.3 (1.6, 11.5)	0.003
Group trend	5.2 (2.4, 11.3)		<0.001	3.4 (1.5, 7.6)		0.003	3.4 (1.5, 7.7)		0.003

Notes: ^aNon-adjusted model adjust for: none; ^bmodel 1 adjust for: age; gender; ^cmodel 2 adjust for: age; gender; anion gap; CHF; liver disease.

Abbreviations: RA, red blood cell distribution width–albumin ratio; DKA, diabetic ketoacidosis; HR, hazard ratio; CI, confidence interval.

Table 3 Association Between RA and Sepsis

	Non-Adjusted^a			Model 1^b			Model 2^c
	HR (95% CIs)	P value	P for Trend	HR (95% CIs)	P value	P for Trend	HR (95% CIs)	P value	P for Trend
Sepsis	2.9 (2.0, 4.1)	<0.001		2.8 (1.9, 4.1)	<0.001		3.0 (1.9, 4.6)	<0.001
Seconde
2.28–3.88	Reference			Reference			Reference
3.89–10.25	7.7 (2.3, 26.3)	0.001		6.6 (1.9, 23.2)	0.003		5.8 (1.6, 20.7)	0.007
Group trend	5.5 (2.0, 15.3)		0.001	4.9 (1.7, 13.8)		0.003	4.3 (1.5, 12.5)		0.007
Sepsis shock	2.8 (1.9, 4.2)	<0.001		2.9 (1.9, 4.3)	<0.001		3.0 (1.9, 4.8)	<0.001
Seconde
2.28–3.88	Reference			Reference			Reference
3.89–10.25	5.3 (1.5, 18.7)	0.009		4.9 (1.4, 17.7)	0.015		4.2 (1.1, 15.8)	0.033
Group trend	4.0 (1.4, 11.5)		0.009	3.8 (1.3, 11.0)		0.015	3.3 (1.1, 10.0)		0.033

Notes: ^aNon-adjusted model adjust for: none; ^bmodel 1 adjust for: age; gender; ^cmodel 2 adjust for: age; gender; anion gap; CHF; liver disease.

Abbreviations: RA, red blood cell distribution width–albumin ratio; HR, hazard ratio; CI, confidence interval.