Objective:

To explore the link between the Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) and the prognosis of sepsis patients.

Approach:

• Study Design: Retrospective cohort study using the MIMIC-IV database to analyze clinical data of sepsis patients.
• Patient Categorization: Patients were categorized into Low-score and High-score groups using X-tile.
• Statistical Analysis: Propensity score matching (PSM) was used to control for confounding factors, with Kaplan-Meier curves and Cox proportional hazards model applied to assess 28-day mortality.
• Predictive Capacity Assessment: ROC curve analysis and subgroup analysis were conducted to evaluate the predictive capacity of HRR.

Key Findings:

• Out of 28,812 sepsis patients, 5,697 (19.77%) died within 28 days.
• Post-PSM, the high-score group had a mortality rate of 20.23%, significantly lower than the low-score group's 25.72% (P < 0.05).
• Cox regression analysis indicated the High-score group had a reduced 28-day mortality risk (HR, 0.73; 95% CI, 0.68–0.79).
• A non-linear relationship between HRR and 28-day mortality was observed (P < 0.05), with a threshold HRR of 0.78 identified.
• When HRR was below 0.78, each one-unit increase in HRR corresponded to a 26% decrease in the 28-day mortality rate (HR, 0.26; 95% CI, 0.19–0.38).

Interpretation:

Limitations:

• The study is retrospective and relies on existing database data, which may have inherent biases.
• The findings may not be generalizable to all sepsis populations outside the MIMIC-IV database.

Conclusion: