Diagnostic accuracy of a dynamically increased red blood cell distribution width in very low birth weight infants with serious bacterial infection

Abstract

Objective Serious bacterial infection (SBI) remains an important cause of morbidity and mortality in preterm infants. The objective of this study was to evaluate the dynamically increased value of the red cell distribution width (RDW) in the diagnosis of SBI. Methods This retrospective study enrolled 334 preterm infants with birth weight less than 1500 g. The initial RDW and the maximum value of RDW during hospitalization were extracted from the MIMIC-III database (version 1.4). Infants were categorized into four groups according to baseline RDW value and ΔRDW (ΔRDW = RDW at maximum- RDW at baseline). Logistic regression analysis was used to assess the risk of developing SBI in each group. A receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of RDW at baseline alone, ΔRDW alone, and in combination. Results Infants with increased RDW at baseline (> 17%) and ΔRDW > 2% exhibited the highest risk of developing SBI, whereas the patients with normal RDW level at baseline (≤ 17%) and ΔRDW≤2% (the reference group) had the lowest risk. This association remained unaltered even after adjustment in multivariable models. Basing on ROC curve analysis, the area under the curve predicted by the combination of RDW at baseline and ΔRDW for SBI was 0.81 (95% CI, 0.76–0.87). Sensitivity and specificity were 78.16 and 72.47% respectively. Conclusions We observed that combination of elevated RDW at baseline and dynamic increases during hospitalization is significantly associated with SBI. Therefore, that combination could be a promising independent diagnostic indicator of SBI in newborns.

Economic and Diagnostic Biomarker Tests of Neonatal Sepsis: A Prospective Study from a Tertiary Care Hospital in a Low-Income Country

“…The finding is in line, as reported by Hu et al, who reported 18.9-19.9% as the diagnostic threshold for neonatal sepsis [51]. Similar other studies support our hypothesis on the diagnostic values of RDW in neonatal sepsis [52][53][54][55][56].…”

ΔRDW Could Predict Major Adverse Cardiovascular Events in Patients with Heart Failure with Reduced Ejection Fraction After Sacubitril/Valsartan Treatment

“…It is used either to record the difference between RDW values at baseline and at various time points after clinical treatment or name unit changes in RDW in the study population by the investigator. ΔRDW has aroused the attention of some researchers in predicting the risk of infection in particular people, 4 early postoperative morbidity, 5 disease survival outcomes, 6 , 7 and risk stratification of patients. 8 …”

Could red cell distribution width be used for predicting cardiac injury in neonates with COVID‐19?

“…The literature data on RDW and its clinical relevance in newborns are scarce, but there are studies showing that high RDW values may be an early prognostic biomarker for outcomes in neonatal sepsis, transient tachypnea of the newborn, critically ill children, and critical pediatric diseases such as severe bacterial infection. 4 , 5 , 6 , 7 , 8 RDW assessment has an important role in determining the severity and prognosis of cardiac autonomic dysfunction and cardiovascular disease in adults. 9 , 10 A number of diseases that are characterized by inflammatory burden are associated with elevated RDW levels, such as autoimmune, 11 gastrointestinal 12 and liver 13 diseases, and malignancy conditions.…”