Association of RDW, NLR, and PLR with Atrial Fibrillation in Critical Care Patients: A Retrospective Study Based on Propensity Score Matching

Abstract

Objective. Previous studies have shown inconsistent results in relation to the red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) of atrial fibrillation (AF). This retrospective study is aimed at detecting the association of RDW, NLR, and PLR with AF. Methods. A total of 4717 critical care patients were screened from the Medical Information Mart for Intensive Care- (MIMIC-) III database. The patients were separated into the non-AF and AF groups. The imbalances between the groups were reduced using propensity score matching (PSM). ROC curves were generated to detect the diagnostic value of RDW, NLR, and PLR. Logistic regression analysis was used to detect the risk factors for AF. Results. A total of 991 non-AF patients paired with 991 AF patients were included after PSM in this study. The RDW level in the AF group was significantly higher than that in the non-AF group ( $15.09\pm 1.93$ vs. $14.89\pm 1.91$ , $P=0.017$ ). Neither NLR nor PLR showed any significant difference between the two groups ( $P>0.05$ for each). According to ROC curve, RDW showed a very low diagnostic value of AF ( $\text{AUC}=0.5341$ ), and the best cutoff of RDW was 14.1 ( $\text{ACU}=0.5257$ , $\text{sensitivity}=0.658$ , $\text{specificity}=0.395$ ). Logistic regression analysis showed that an elevated RDW level increased 1.308-fold ( $95\%\text{CI}=1.077$ -1.588, $P=0.007$ ) risk of AF. Neither elevated NLR nor elevated PLR was a significant risk factor for AF ( $\text{OR}=0.993$ , $95\%\text{CI}=0.802$ -1.228, $P=0.945$ for NLR; $\text{OR}=0.945$ , $95\%\text{CI}=0.763$ -1.170, $P=0.603$ for PLR). Conclusions. Elevated RDW level but not NLR or PLR levels is associated with AF. $\text{RDW}>14.1$ is a risk factor for AF, but its diagnostic capacity for AF is not of great value.