Correlation of red cell distribution width-to-albumin ratio combined with SOFA score with 28-day all-cause mortality in patients with acute pancreatitis: A retrospective study based on the MIMIC-IV database

OBJECTIVES: The objective of this study is to evaluate the effectiveness of the red cell distribution width-to-albumin ratio (RAR) in conjunction with the Sequential Organ Failure Assessment (SOFA) score for predicting 28-day all-cause mortality in patients with acute pancreatitis (AP). METHODS: In this study, we conducted a retrospective analysis of clinical data from 702 patients with AP sourced from the MIMIC-IV (v3.1) database. We evaluated the relationship between the RAR-modified SOFA score and 28-day all-cause mortality using both univariate and multivariate Cox regression analyses. Furthermore, the optimal cutoff value was determined using the Youden index, and the predictive performance of the combined indicator was evaluated through Receiver Operating Characteristic (ROC) curves and Kaplan-Meier (K-M) survival analysis. Finally, we examined the robustness of our findings across different populations through subgroup analyses. RESULTS: A total of 702 patients with AP admitted to the Intensive Care Unit (ICU) were included in this study, and their 28-day all-cause mortality was analyzed. Both univariate and multivariate Cox regression analyses indicated that the RAR-modified SOFA score served as an independent risk factor for 28-day all-cause mortality in ICU patients with AP. ROC curve analysis demonstrated that the RAR-modified SOFA score exhibited superior predictive ability compared to other scoring systems, including RAR and SOFA alone. Additionally, K-M survival curve analysis revealed that the mortality rate was significantly higher in the high-value group (RAR-modified SOFA score ≥ 12.69) compared to the low-value group (RAR-modified SOFA score < 12.69). CONCLUSIONS: The RAR-modified SOFA score significantly enhances the predictive accuracy for 28-day all-cause mortality in patients with AP.