The role of red cell distribution width as a predictor of mortality for critically ill patients in an inner-city hospital

Abstract

Background:Red cell distribution width (RDW) is a measure of the variation in the red blood cell volume that is usually recorded as a part of the standard complete blood cell count. Recent studies have demonstrated the prognostic value of RDW in many different clinical settings. The objective of this research study is to investigate the independent association of RDW with 30-day mortality in Intensive Care Unit (ICU) patients.Methods:One hundred and fifty-six patients admitted to the ICU of our hospital between July 2009 and June 2011 were included in our study. Out of 156 patients, 124 survived the hospital stay. The data on patient's demographics, interventions done in ICU, and their comorbidities were collected. Baseline variables and the RDW value were compared between survivors and nonsurvivors. The cutoff point for RDW used for the comparison was 15.75. Both univariable and multivariable analyses were done. P < 0.05 was considered statistically significant.Results:In the univariable analysis of the study between survivors and nonsurvivors, the median RDW was 17.20 for nonsurvivors, implying statistical significance (P = 0.007). In multivariable analysis, RDW remained significantly associated with inpatient mortality. The receiver operating characteristic is 0.656 (P = 0.007), with an optimal cutoff of 15.75 for RDW. At the cutoff of RDW, i.e., 15.75, the sensitivity and specificity for inpatient mortality was 71% and 89%, respectively.Conclusion:In critically ill ICU patients, RDW is an independent predictor of 30-day mortality. Taking into consideration the fact that RDW is routinely measured in complete blood count with no additional cost, this can serve as an “inexpensive prognostic marker” in critically ill patients.

High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

“…6,18 Similarly several studies have been conducted on children in paediatric intensive care units which have also found an association of high RDW with mortality. 5,[13][14][15]19,20 However some other studies have found that there is no relation between high RDW and mortality in children. 13,21 Said et al also found a significant relation between admission RDW as well as relative RDW (calculated as the difference between the first day RDW and highest of the first seven days RDW divided by admission RDW) with mortality.…”

“…[1][2][3][4] But in recent years, there has been considerable interest in its use as a predictive marker of adverse outcomes in several adult diseases like autoimmune diseases, sepsis, cardiac and pulmonary diseases, operative diseases and critical illnesses. [3][4][5][6][7][8][9][10][11] Many such studies have shown promising use of RDW as a predictive marker of mortality in adults.…”

Red Cell Distribution Width as a Novel Prognostic Marker in Multiple Clinical Studies

“…Researchers suggested that the use of this parameter as an inexpensive prognostic marker in addition to other scores such as APACHE improves the prognostication of patients, especially critically ill ones. 7,[57][58][59] conclusIon It seems that this simple and inexpensive test provides valuable information about the general health status, different diseases, clinical outcomes, complications, and mortality, regardless of the underlying disorder. Therefore, patients with increased RDW values should be more closely and intensively managed to improve their clinical outcomes.…”

Hematologic Derangements among Children with Unoperated Cyanotic Congenital Heart Disease in Ethiopia

“…Thrombocytopenia was defined as platelet count of <150,000 per microliter of blood ( 18 ), and sub-classified as mild (101,000-140,000/microliter), moderate (51,000-100,000/microliter), severe (21,000-50,000/microliter) and very severe (≥20,000). High red cell distribution width (RDW) was defined as > 15.5% ( 19 ).…”