Background Red cell distribution width (RDW) and serum albumin concentration are associated with postoperative outcomes. However, the usefulness of the RDW/albumin ratio in burn surgery remains unclear. Therefore, we evaluated the association between RDW/albumin ratio and 90-day mortality after burn surgery. Methods Between 2013 and 2020, a retrospective review of patients in a burn intensive care unit (ICU) was performed. Receiver operating characteristic curve, multivariate Cox logistic regression, multivariate logistic regression and Kaplan–Meier analyses were conducted to evaluate the association between RDW/albumin ratio and 90-day mortality after burn surgery. Additionally, prolonged ICU stay rate (>60 days) and ICU stay were assessed. Results Ninety-day mortality was 22.5% (210/934) in burn patients. Risk factors for 90-day mortality were RDW/albumin ratio at postoperative day 1, age, American Society of Anesthesiologists physical status, diabetes mellitus, inhalation injury, total body surface area burned, hypotensive event and red blood cell transfusion volume. The area under the curve of the RDW/albumin ratio at postoperative day 1 to predict 90-day mortality, after adjusting for age and total body surface area burned, was 0.875 (cut-off value, 6.8). The 90-day mortality was significantly higher in patients with RDW/albumin ratio >6.8 than in those with RDW/albumin ratio ≤6.8 (49.2% vs 12.3%, p < 0.001). Prolonged ICU stay rate and ICU stay were significantly higher and longer in patients with RDW/albumin ratio >6.8 than in those with RDW/albumin ratio ≤6.8 (34.5% vs 26.5%; 21 [11–38] vs 18 [7–32] days). Conclusion RDW/albumin ratio >6.8 on postoperative day 1 was associated with higher 90-day mortality, higher prolonged ICU stay rate and longer ICU stay after burn surgery.

中文翻译：

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烧伤手术后红细胞分布宽度/白蛋白比和90天死亡率

背景 红细胞分布宽度 (RDW) 和血清白蛋白浓度与术后结果相关。然而，RDW/白蛋白比值在烧伤手术中的有用性仍不清楚。因此，我们评估了 RDW/白蛋白比率与烧伤手术后 90 天死亡率之间的关联。方法 2013 年至 2020 年间，对烧伤重症监护病房（ICU）的患者进行回顾性分析。采用受试者工作特征曲线、多变量 Cox 逻辑回归、多变量逻辑回归和 Kaplan-Meier 分析来评估 RDW/白蛋白比值与烧伤手术后 90 天死亡率之间的关联。此外，评估了延长的 ICU 停留率（＞60 天）和 ICU 停留时间。结果烧伤患者90天死亡率为22.5%（210/934）。90 天死亡率的危险因素是术后第 1 天的 RDW/白蛋白比率、年龄、美国麻醉医师协会的身体状况、糖尿病、吸入性损伤、全身烧伤表面积、低血压事件和红细胞输血量。术后第 1 天 RDW/白蛋白比率预测 90 天死亡率的曲线下面积，在调整年龄和烧伤总体表面积后，为 0.875（临界值，6.8）。RDW/白蛋白比值＞6.8 的患者的 90 天死亡率显着高于 RDW/白蛋白比值≤6.8 的患者（49.2% vs 12.3%，p < 0.001）。与 RDW/白蛋白比率≤6.8 的患者相比，RDW/白蛋白比率 > 6.8 的患者的 ICU 停留率和 ICU 停留时间显着更高和更长（34.5% vs 26.5%；21 [11-38] vs 18 [7- 32] 天）。