Vasculitis & polymyalgia rheumatica
Associations between age, red cell distribution width and 180-day and 1-year mortality in giant cell arteritis patients: mediation analyses and machine learning in a cohort study
Authors' conclusion
Older age and higher RDW levels were identified as independent risk factors for increased 180-day and 1-year mortality in GCA patients hospitalized or admitted to the ICU. Furthermore, elevated RDW levels modestly mediated the relationship between age and 180-day or 1-year mortality in this patient population.
Study context
- Population
- Giant cell arteritis (GCA) patients hospitalized or admitted to the ICU, MIMIC-IV (3.0) database
- Participants
- 228 patients
- Exposure
- Older vs younger age and higher vs lower RDW
- Outcome
- 180-day and 1-year mortality
- Follow-up
- 180 days and 1 year
Methodological detailsMIMIC-IV (3.0) database, multivariate logistic and Cox regression, Kaplan-Meier (KM) survival analysis, restricted cubic spline (RCS) analysis, mediation analysis, machine learning with SHAP analysis
- MIMIC-IV (3.0) database
- Multivariate logistic and Cox regression
- KM survival analysis
- RCS analysis
- Mediation analysis
- Machine learning with SHAP analysis
Main finding
As reported in the abstract
- Age and RDW significant predictors in multivariate logistic regression (both OR > 1, P < 0.05)
- Age and RDW prognostic risk factors in multivariate Cox regression (both HR > 1, P < 0.05)
- Higher age or elevated RDW: significantly lower survival (KM; P < 0.0001)
Observational data: associations, not effects.
Further findings
Nonlinear relationship between RDW and 1-year mortality (RCS)
- Strong nonlinear relationship; RDW threshold
- 17.53%
Mediation by RDW of age (per 10-year increase)–mortality relationship · 180 days and 1 year
- RDW modestly mediated the relationship
Machine learning prediction of mortality
- Random forest model performed best, AUC
- 0.879
- SHAP: age and RDW made significant contributions to prediction
Original publication
Associations between age, red cell distribution width and 180-day and 1-year mortality in giant cell arteritis patients: mediation analyses and machine learning in a cohort study. Arthritis Res Ther. Published 8 February 2025. doi:10.
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