Jian et al. found that an RAR cutoff >4.776%dL/g (AUC 0.738) was significantly associated with in-hospital all-cause mortality among ICU patients with acute myocardial infarction and that RAR was a more accurate predictor than RDW or albumin alone [14]. Our findings extend these observations, further supporting RAR as a negative prognostic marker across a broad spectrum of acute illnesses, including COPD. Here, ALB is linked to chronic obstructive pulmonary disease.