{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:17:18Z","timestamp":1783574238440,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Red blood cell distribution width (RDW)\u2010derived indicators have increasingly been recognized as biomarkers reflecting systemic inflammation and hematological disorders. However, the prognostic value of these indicators in critically ill patients with pulmonary hypertension (PH), especially the dynamic implications of their temporal changes, remains insufficiently elucidated. A total of 990 adult patients diagnosed with PH in the intensive care unit (ICU) based on ICD\u20109\/10 codes were enrolled from the MIMIC\u2010IV database. The association between baseline levels of three key indicators and the 1\u2010year all\u2010cause mortality risk was assessed using Cox proportional hazards models and restricted cubic spline (RCS) analysis, and the consistency of this association was assessed for external consistency in the eICU\u2010CRD cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009298) and NWICU cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009182). In the subgroup of patients with \u2265\u20093 consecutive laboratory tests (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009316), group\u2010based multi\u2010trajectory modeling (GBTM) was employed to identify the joint longitudinal trajectory patterns of these three indicators. The robustness of the prediction results was then evaluated using machine learning models as secondary exploratory analysis. In the MIMIC\u2010IV cohort, higher baseline RAR (aHR = 1.17, 95% CI: 1.08\u20131.27) and RPR (aHR = 2.31, 95% CI: 1.38\u20133.86) were significantly associated with increased 1\u2010year mortality risk, whereas higher HRR exerted a protective effect (aHR = 0.31, 95% CI: 0.17\u20130.58). Across the multiple cohorts, only RAR remained statistically significant in the multivariate model of the eICU\u2010CRD cohort (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009); although RPR and HRR showed a consistent association, the results did not reach statistical significance. GBTM identified three distinct joint trajectory patterns. Compared with the reference group (Class 2), the high\u2010risk trajectory group (Class 3,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935) exhibited a significantly elevated mortality risk (aHR = 2.48). In the exploratory analysis, the support vector machine (SVM) demonstrated moderate discriminative ability (AUC\u2009=\u20090.782). RDW\u2010derived indicators are independently associated with the mortality risk in critically ill patients with ICD\u2010code defined PH. Both their baseline levels and short\u2010term change trajectories may reflect the severity of the underlying disease and systemic stress response. These findings suggest that RDW\u2010derived indicators play an important role in risk phenotyping; however, prospective studies are warranted to confirm their clinical significance.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70314","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:37:10Z","timestamp":1778495830000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Red Blood Cell Distribution Width\u2010Derived Indicators and Their Longitudinal Dynamic Trajectories With Mortality Risk in Critically Ill Patients With Pulmonary Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4165-1486","authenticated-orcid":false,"given":"Anxin","family":"He","sequence":"first","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Respiratory Diseases of Education Department of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Lu","sequence":"additional","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Respiratory Diseases of Education Department of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Liu","sequence":"additional","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Respiratory Diseases of Education Department of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Liang","sequence":"additional","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Respiratory Diseases of Education Department of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xutong","family":"Fan","sequence":"additional","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Respiratory Diseases of Education Department of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Luo","sequence":"additional","affiliation":[{"name":"The Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key Laboratory of Basic Research on Respiratory Diseases of Health Commission of Guangxi Zhuang Autonomous Region The First Affiliated Hospital of Guilin Medical University Guilin China"},{"name":"The Key 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