Abstract:

Objective To investigate the predictive value of admission red blood cell distribution width （RDW）for early postoperative major adverse events in heart transplant recipients. Methods Clinical data of 57 patients who underwent heart transplantation at Central China Fuwai Hospital of Zhengzhou University between April 2018 and December 2024 were retrospectively analyzed. Patients were stratified into a favorable prognosis group （n ＝ 44）and an adverse prognosis group（n ＝ 13）based on the occurrence of major adverse events within 30 days postoperatively（all-cause death，reoperation for any cause，requirement for extracorporeal membrane oxygenation，or new-onset continuous renal replacement therapy）. Risk factors were screened using logistic regression analysis，and predictive performance was evaluated using receiver operating characteristic（ROC）curves. Results AdmissionRDW was significantly higher in the adverse prognosis group compared to the favorable prognosis group（15.69 ±1.32% vs. 14.70±1.56%，P ＝ 0.043）. Multivariate logistic regression analysis identified admission RDW as an independent risk factor for early postoperative adverse events（OR ＝ 1.875，95% CI ＝ 1.053 ～ 3.341，P ＝ 0.033）. The area under the ROC curve was 0.704（P ＝ 0.027），with an optimal cutoff value of 15.5%（sensitivity was 61.5%，specificity was 75.0%）. Conclusion Elevated admission RDW independently correlates with early major adverse events following heart transplantation and may serve as a potential biomarker for preoperative risk assessment. 

Key words:

 , Red blood cell distribution width, Heart transplantation, Heart failure, Biomarker

摘要：

目的 探讨入院首个红细胞分布宽度（red blood cell distribution width，RDW）对心脏移植患者术后早期主要不良事件的预测价值。 方法 回顾性分析 2018 年 4 月至 2024 年 12 月在郑州大学华中阜外医院接受心脏移植的 57 例患者的临床资料。根据术后 30 d 内是否发生主要不良事件（全因死亡、任何原因的二次手术、应用体外膜肺氧合或新应用连续性肾脏替代治疗）分为预后良好组（n ＝ 44）与预后不良组（n ＝ 13）。通过 Logistic 回归分析筛选危险因素，并采用受试者工作特征曲线评估预测效能。 结果 预后不良组入院 RDW 高于预后良好组（15.69±1.32 比 14.70±1.56，P ＝ 0.043）。多因素 Logistic 回归分析显示，入院RDW是心脏移植术后早期预后不良的独立危险因素（OR＝1.875，95% CI＝1.053～3.341，P＝0.033），其曲线下面积为 0.704（P ＝ 0.027），最佳截断值为 15.5%（灵敏度为 61.5%，特异度为 75.0%）。 结论 高入院 RDW 与心脏移植早期主要不良事件发生独立相关，可作为心脏移植术前风险评估的潜在生物标志物。

关键词:

 , 红细胞分布宽度 , 心脏移植 , 心力衰竭 , 生物标志物