Related Experiment Videos
Red cell distribution width and all-cause mortality in critically ill patients.
Heidi S Bazick1, Domingo Chang, Karthik Mahadevappa
1Department of Anesthesiology, Massachusetts General Hospital, Boston, MA, USA.
Critical Care Medicine
|May 3, 2011
Summary
Increased red cell distribution width (RDW) in critically ill patients predicts mortality and bloodstream infections. This readily available measure can help assess patient risk in intensive care units.
Area of Science:
- Critical Care Medicine
- Hematology
- Clinical Pathology
Background:
- Red cell distribution width (RDW) is a known predictor of mortality in the general population.
- The prevalence and significance of elevated RDW in intensive care unit (ICU) patients are not well-established.
Purpose of the Study:
- To investigate the association between RDW at the initiation of critical care and all-cause mortality.
- To determine the prevalence and significance of increased RDW in critically ill patients.
Main Methods:
- A multicenter observational study involving 51,413 adult patients admitted to the ICU.
- RDW was categorized into quintiles and analyzed for association with 30-day, 90-day, and 365-day mortality, as well as in-hospital mortality and bloodstream infections.
- Multivariable logistic regression models were used to adjust for various clinical factors.
Main Results:
- Elevated RDW was a significant predictor of all-cause mortality across all time points (30, 90, 365 days) and in-hospital mortality.
- A clear risk gradient was observed, with the highest RDW quintile (>15.8%) showing a 2.61-fold increased odds of 30-day mortality.
- RDW was also associated with an increased risk of bloodstream infections in a subanalysis.
Conclusions:
- Red cell distribution width is a robust, inexpensive, and widely available predictor of mortality and bloodstream infection risk in critically ill patients.
- Elevated RDW may indicate underlying inflammation, oxidative stress, or arterial underfilling in the ICU population.
Related Concept Videos
01:27Disorders of Erythrocytes
Disorders of erythrocytes, or red blood cells (RBCs), include a range of conditions affecting their number, shape, or function.
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
01:20Volume of Distribution
The apparent volume of distribution (Vd) is a crucial pharmacokinetic parameter representing the hypothetical body fluid volume into which a drug disperses. It is calculated based on the total amount of drug in the body (estimated from the administered dose and bioavailability) divided by the plasma drug concentration. The total amount of drug in the body does not directly refer to the dose given but is derived by accounting for absorption, distribution, metabolism, and excretion processes.