Introduction

Acute pulmonary embolism (APE) is a typical cardiovascular emergency worldwide. Mean hemoglobin concentration (MCHC) is a standard indicator of anemia. Studies on the association between MCHC and APE are scarce. We aimed to investigate the relationship between MCHC and APE.

Methods

Clinical data were extracted from the Medical Information Bank for Intensive Care (MIMIC)-III. Adult (≥18 years) patients with APE admitted for the first time were included in this study. An analysis was conducted to evaluate the association between MCHC and the prognosis of patients by the Cox regression analysis, generalized additives models and Kaplan–Meier survival curves. The primary outcome was 30-day mortality, and the secondary outcomes were 1-year and 3-year mortality.

Results

A total of 813 patients who met the selection criteria were enrolled, of whom 130 (16.0%) died within 30 days of admission. Univariate Cox regression indicated that MCHC was significantly associated with mortality (30-day: HR = 0.74, 95% CI = 0.66–0.82, P < 0.001; 1-year: HR = 0.80, 95% CI = 0.74–0.86, P < 0.001; 3-year: HR = 0.82, 95% CI = 0.77–0.88, P < 0.001). MCHC remains stable after adjusting multiple models. Kaplan-Meier survival curves showed that patients with lower MCHC had a poorer 30-day prognosis.

Conclusions

Lower MCHC is an independent risk factor for increased mortality in patients with APE. As an inexpensive biomarker, MCHC should receive more attention.

中文翻译：

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急性肺栓塞患者平均红细胞血红蛋白浓度与预后的关系：一项回顾性队列研究

介绍

急性肺栓塞（APE）是世界范围内典型的心血管急症。平均血红蛋白浓度 (MCHC) 是贫血的标准指标。关于 MCHC 和 APE 之间关联的研究很少。我们旨在调查 MCHC 和 APE 之间的关系。

方法

临床数据来自重症监护医学信息库 (MIMIC)-III。首次入院的成人（≥18 岁）APE 患者纳入本研究。通过 Cox 回归分析、广义添加剂模型和 Kaplan-Meier 生存曲线进行分析以评估 MCHC 与患者预后之间的关联。主要结局是 30 天死亡率，次要结局是 1 年和 3 年死亡率。

结果

共纳入符合选择标准的813例患者，其中130例（16.0%）在入院30天内死亡。单变量 Cox 回归表明 MCHC 与死亡率显着相关（30 天：HR = 0.74，95% CI = 0.66–0.82，P  < 0.001；1 年：HR = 0.80，95% CI = 0.74–0.86，P  < 0.001；3 年：HR = 0.82，95% CI = 0.77–0.88，P  < 0.001）。调整多个模型后，MCHC 保持稳定。Kaplan-Meier 生存曲线显示，MCHC 较低的患者 30 天预后较差。

结论

较低的 MCHC 是 APE 患者死亡率增加的独立危险因素。作为一种廉价的生物标志物，MCHC应该受到更多的关注。