Association between platelet-to-red cell distribution width ratio and all-cause mortality in critically ill patients with non-traumatic cerebral hemorrhage: a retrospective cohort study

Background The purpose of this study was to investigate the relationship between platelet-to-red cell distribution width ratio (PRR) and all-cause mortality in critically ill patients with non-traumatic cerebral hemorrhage (NCH).Methods The Medical Information Mart for Intensive Care (MIMIC-IV) database was used to identify patients with NCH who needed to be admitted to intensive care unit (ICU). The outcomes of the study included both ICU and in-hospital mortality. Restricted cubic splines and Cox proportional hazards regression analysis were used to clarify the relationship between PRR and clinical outcomes in critically ill patients with NCH.Results A total of 3,094 patients (54.0% male) were included in the study, with in-hospital mortality and ICU mortality rates of 16.5 and 11.8%, respectively. A substantial correlation was found by multivariate Cox proportional hazards analysis between increased PRR and a lower risk of in-hospital and ICU mortality. Following adjustment for confounding factors, patients with elevated PRR exhibited a significantly decreased risk of in-hospital death (HR, 0.98; 95% CI, 0.96-0.99; p = 0.006) and ICU death (HR, 0.98; 95% CI, 0.96-0.99; p = 0.027). As PRR increased, restrictive cubic splines showed a progressive decrease in the probability of all-cause mortality. Stratified analyses indicated a consistent association between PRR and both in-hospital and ICU mortality.Conclusion Among critically ill patients with NCH, lower PRR was substantially correlated with the increased probability of all-cause mortality in both the ICU and hospital. According to this research, PRR might be a valuable indicator for identifying NCH patients at risk of all-cause mortality.