HCT-ALB difference as a predictor of 90-day all-cause mortality in non-elderly patients with acute pancreatitis admitted to the ICU: A retrospective analysis of the MIMIC-IV database

The difference between hematocrit (HCT) and plasma albumin (ALB), denoted as HCT-ALB, has been proposed as a new predictor of sepsis and infectious diseases, among others. The role of this index in predicting all-cause mortality in patients with acute pancreatitis (AP), however, has not been evaluated. The aim of this study was therefore to elucidate the correlation between HCT-ALB and 90-day all-cause mortality in non-elderly patients with AP. This retrospective cohort study utilized data from the MIMIC-IV (v1.0) database and included non-elderly adult patients diagnosed with AP who were admitted to the intensive care unit during the study. The primary outcome was the ability of HCT-ALB to predict mortality within 90 days of admission. A total of 254 patients met the inclusion criteria, and the mortality rate at 90 days after admission was 11.8%. A significant difference in HCT-ALB was observed between survivor and nonsurvivor groups, and the area under the receiver operating characteristic curve for predicting 90-day mortality was 0.692, with an optimal threshold value of 9.05 as calculated by the Youden Index. When modeled for prediction using HCT-ALB, age, and blood urea nitrogen, the predictive model showed good predictive efficacy. In conclusion, HCT-ALB serves as an independent predictor of all-cause mortality within 90 days of admission in non-elderly patients with AP. A predictive model that integrates HCT-ALB with age and serum urea nitrogen shows strong predictive efficacy.