The red blood cell distribution width is associated with all-cause and cardiovascular mortality among individuals with non-alcoholic fatty liver disease

by Yingxiu Huang, Ting Ao, Yinying Wang, Peng Zhen, Ming Hu

Background

Identifying reliable prognostic indicators is essential for the appropriate management of non-alcoholic fatty liver disease (NAFLD).Red blood cell distribution width (RDW) has been established as an inflammatory marker associated with cardiovascular outcomes. This study aimed to evaluate the association between RDW and both cardiovascular and all-cause mortality in individuals with NAFLD.

Methods

Data from 7,438 participants with NAFLD were analyzed, collected between 2005 and 2016 through the National Health and Nutrition Examination Survey (NHANES). Mortality data were retrieved from the National Death Index (NDI). Restricted cubic spline (RCS) analysis was used to illustrate the relationship between RDW and mortality risk, Weighted Cox proportional hazards models were used to assess the independent relationship between RDW and mortality risk. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive ability of RDW for survival outcomes.

Results

During a median follow-up period of 124 months, 1,269 deaths were recorded, including 335 from cardiovascular causes. RDW positively correlated with both cardiovascular and all-cause mortality according to the RCS analysis. Participants were categorized into quartiles based on RDW levels. Those in the highest RDW quartile (Q4) demonstrated a significantly higher risk of cardiovascular mortality (HR 3.61, 95% confidence interval [CI]:2.17–6.02, P=0.009) and all-cause mortality (HR 2.29, 95% CI:1.72–3.06, P Conclusion

Among patients with NAFLD, RDW was identified as an independent predictor of increased cardiovascular and all-cause mortality risk.

Hypnotic drug use and intraoperative fluid balance associated with postoperative delirium following pancreatic surgery: A retrospective, observational, single-center study

by Zhi-Hua Huang, Jun Zhang, Xiao-ying Xu, Ying Wang, Xiao-jian Lu, Yan Luo

Background

Postoperative delirium is a common complication after various types of major surgery. The aim of this study was to identify risk factors associated with delirium following pancreatic surgery.

Methods

Data from the patients who had pancreatic surgery between July 2020 and March 2021 in Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine were retrospectively analysed. The postoperative risk factors related to delirium were analyzed by univariate and multivariate Logistic regression analysis.

Results

59 of 385 patients (15.3%) developed postoperative delirium after pancreatic surgery. The ROC curve revealed the optimal cutoff of intraoperative fluid balance was 2863ml. Furthermore, the multivariate analysis demonstrated that age ≥  65 years old [Odds ratio (OR) 2.01; 95% Confidence interval (CI) 1.12-3.63; p =  0.019], hypnotic drug use (OR 4.17; 95% CI 1.50-11.10; p =  0.005), and intraoperative fluid balance (OR 2.57; 95% CI 1.37-4.84; p =  0.003) were the independent risk factors of postoperative delirium.

Conclusion

This study identified that intraoperative fluid balance and hypnotic drug use were independent risk factors associated with postoperative delirium development after pancreatic surgery.