---
title: "Hemoglobin-to-RDW Ratio (HRR) and ICU Outcomes in Traumatic Brain Injury Patients"
id: "pubmed-42770772"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42770772"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42770772/"
doi: "10.1080/02699052.2026.2735358"
published_at: "2026-09-22T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Hemoglobin-to-RDW Ratio (HRR) and ICU Outcomes in Traumatic Brain Injury Patients
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42770772
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42770772/)
- **DOI:** [10.1080/02699052.2026.2735358](https://doi.org/10.1080%2F02699052.2026.2735358)
- **Published At:** 2026-09-22T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Purpose: The study evaluated the prognostic value of the **hemoglobin-to-red cell distribution width ratio (HRR)** in adult patients with traffic-related traumatic brain injury (TBI) admitted to an intensive care unit (ICU). - Cohort and setting: Retrospective review of 105 adult patients with traffic-related TBI treated at a Level I trauma center in Taiwan between 2016 and 2017. Inclusion required Head and Neck Abbreviated Injury Scale (AIS) score ≥ 3. - HRR measurement and cutoff: HRR was calculated from admission laboratory values; the cohort was dichotomized using the cohort median HRR of **1.057** into low- and high-HRR groups. - Primary outcomes: In-hospital mortality and prolonged hospital length of stay (LOS). - Key baseline differences: Patients in the low-HRR group were older, had a higher proportion of females, and a greater prevalence of diabetes compared with the high-HRR group. - Main findings: After adjustment for clinical variables, a **higher HRR** was independently associated with significantly lower odds of prolonged hospital LOS. HRR was not significantly associated with in-hospital mortality after adjustment. - Interpretation: HRR may serve as an independent predictor of prolonged hospitalization risk among ICU patients with TBI, but it did not predict in-hospital death in this cohort. - Data constraints: The published abstract reports core results and the median cutoff but does not provide the full list of covariates included in adjusted models, effect estimates, confidence intervals, or detailed statistical methods in the abstract text. - Clinical implication: HRR is a readily available hematologic index that might help risk-stratify TBI patients for expected hospital LOS; further detailed reporting and external validation would be needed before clinical adoption.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Prognostic role of hemoglobin-to-RDW ratio for clinical outcomes in traumatic brain injury patients admitted to the intensive care unit: a retrospective analysis [Kuan-Kai Lai](https://pubmed.ncbi.nlm.nih.gov/?term=Lai+KK&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#full-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Chun-Man Kuo](https://pubmed.ncbi.nlm.nih.gov/?term=Kuo+CM&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#full-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Ching-Lin Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+CL&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#full-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.") Affiliations Expand ### Affiliation * 1 Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * PMID: **42770772** * DOI: [ 10.1080/02699052.2026.2735358 ](https://doi.org/10.1080/02699052.2026.2735358) Item in Clipboard # Prognostic role of hemoglobin-to-RDW ratio for clinical outcomes in traumatic brain injury patients admitted to the intensive care unit: a retrospective analysis Kuan-Kai Lai et al. Brain Inj. 2026. Show details Display options Display options Format Abstract PubMed PMID Brain Inj Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Brain+Inj%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Brain+Inj%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770772/) . 2026 Sep 22:1-7. doi: 10.1080/02699052.2026.2735358. Online ahead of print. ### Authors [Kuan-Kai Lai](https://pubmed.ncbi.nlm.nih.gov/?term=Lai+KK&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#short-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Chun-Man Kuo](https://pubmed.ncbi.nlm.nih.gov/?term=Kuo+CM&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#short-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Ching-Lin Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+CL&cauthor_id=42770772)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770772/#short-view-affiliation-1 "Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.") ### Affiliation * 1 Division of Trauma, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * PMID: **42770772** * DOI: [ 10.1080/02699052.2026.2735358 ](https://doi.org/10.1080/02699052.2026.2735358) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Purpose:** The hemoglobin-to-red cell distribution width ratio (HRR) has emerged as a potential biomarker in various clinical contexts, but its role in Traumatic brain injury (TBI) is unclear. **Materials and methods:** The records of adult patients with traffic-related TBI admitted to the ICU of a Level-I Trauma Center in Taiwan between 2016 and 2017 were retrospectively reviewed. Included patients had a Head and Neck Abbreviated Injury Scale (AIS) score ≥ 3. The primary outcomes were in-hospital mortality and prolonged hospital length of stay (LOS). Using the median HRR value of 1.057 as the cutoff, patients were categorized into the low HRR group and high HRR group. **Results:** A total of 105 patients were included in the analysis. Patients in the low HRR group were older, more likely to be female, and had a higher prevalence of diabetes. After adjusting for clinical variables, In the dichotomized analysis, the high HRR group had significantly lower odds of prolonged hospital LOS than the low HRR group after adjustment. **Conclusions:** A higher HRR was independently associated with a lower likelihood of prolonged hospital stay among patients with TBI admitted to the ICU. However, HRR was not significantly associated with in-hospital mortality after adjustment. **Keywords:** Hemoglobin-to-RDW ratio; clinical outcomes; intensive care unit; traumatic brain injury. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ [Prognostic value of hemoglobin-to-red cell distribution width ratio in patients with cardiopulmonary resuscitation after out-of-hospital cardiac arrest]. ](https://pubmed.ncbi.nlm.nih.gov/37803955/) Wang H, Lan C, Luo Y, Zhang T.Wang H, et al.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Sep;35(9):958-962. doi: 10.3760/cma.j.cn121430-20230207-00066.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023.PMID: 37803955Chinese. * [ Hemoglobin-to-Red Cell Distribution Width Ratio is Associated with All-Cause Mortality in Critically Ill Patients with Traumatic Brain Injury. ](https://pubmed.ncbi.nlm.nih.gov/37466062/) Yang D, Lan J, Xue R, Zhang K, Ye S, Huang Z, Zhang L.Yang D, et al.Neuro Endocrinol Lett. 2023 Jul 5;44(4):223-233.Neuro Endocrinol Lett. 2023.PMID: 37466062 * [ Prognostication of traumatic brain injury outcomes in older trauma patients: A novel risk assessment tool based on initial cranial CT findings. ](https://pubmed.ncbi.nlm.nih.gov/28382256/) Stawicki SP, Wojda TR, Nuschke JD, Mubang RN, Cipolla J, Hoff WS, Hoey BA, Thomas PG, Sweeney J, Ackerman D, Hosey J, Falowski S.Stawicki SP, et al.Int J Crit Illn Inj Sci. 2017 Jan-Mar;7(1):23-31. doi: 10.4103/IJCIIS.IJCIIS_2_17.Int J Crit Illn Inj Sci. 2017.PMID: 28382256Free PMC article. * [ Pediatric sports-related traumatic brain injury in United States trauma centers. ](https://pubmed.ncbi.nlm.nih.gov/27032920/) Yue JK, Winkler EA, Burke JF, Chan AK, Dhall SS, Berger MS, Manley GT, Tarapore PE.Yue JK, et al.Neurosurg Focus. 2016 Apr;40(4):E3. doi: 10.3171/2016.1.FOCUS15612.Neurosurg Focus. 2016.PMID: 27032920 * [ Prognostic value of hemoglobin-to-red cell distribution width ratio in cancer: a systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/35272482/) Chi G, Lee JJ, Montazerin SM, Marszalek J.Chi G, et al.Biomark Med. 2022 Apr;16(6):473-482. doi: 10.2217/bmm-2021-0577. 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