Related Experiment Videos
Red cell distribution width and outcome in patients with septic shock
Farid Sadaka1, Jacklyn O'Brien, Sumi Prakash
1Critical Care Medicine department, Mercy Hospital St Louis, St. Louis University, St Louis, MO, USA.
Journal of Intensive Care Medicine
|July 20, 2012
Summary
Red cell distribution width (RDW) on day 1 of septic shock strongly predicts hospital mortality. This inexpensive test, when combined with APACHE II, offers superior mortality prediction compared to existing scoring systems.
Area of Science:
- Critical Care Medicine
- Hematology
- Clinical Pathology
Background:
- Red cell distribution width (RDW) is a marker of systemic inflammation.
- RDW reflects variations in red blood cell size.
Purpose of the Study:
- To investigate the association between RDW on day 1 of septic shock and patient mortality.
- To evaluate RDW's predictive performance against established scoring systems.
Main Methods:
- A cohort of 279 patients with septic shock was analyzed.
- Patients were categorized into quintiles based on initial RDW values.
- Multivariable analysis and receiver-operating characteristic (ROC) curves were used.
Main Results:
- Higher RDW quintiles were significantly associated with increased hospital and ICU mortality.
- RDW demonstrated strong discriminative power for hospital mortality (AUC = 0.74).
- Combining RDW with APACHE II improved mortality prediction (AUC increased from 0.69 to 0.77).
Conclusions:
- RDW is a robust, inexpensive, and readily available predictor of mortality in early septic shock.
- RDW alone outperformed APACHE II and SOFA scores in predicting mortality.
- The combination of RDW and APACHE II provides enhanced prognostic capability.