Elevated Red Cell Distribution Width as a Prognostic Marker in Severe Sepsis: A Prospective Observational Study

Area of Science:

• Critical Care Medicine
• Hematology

Background:

• Sepsis is a life-threatening organ dysfunction due to infection.
• Red cell distribution width (RDW) is a routinely measured hematological parameter.
• RDW's prognostic value in sepsis requires further investigation.

Purpose of the Study:

• To evaluate the association between red cell distribution width (RDW) and 30-day mortality in severe sepsis patients.
• To determine if RDW is an independent predictor of mortality in severe sepsis.

Main Methods:

• Prospective evaluation of 200 severe sepsis patients.
• Analysis of red cell distribution width (RDW) at admission.
• Categorization into three RDW groups: ≤14.5%, 14.6-17.3%, and >17.3%.
• Multivariate logistic regression to identify independent predictors of 30-day mortality.

Main Results:

• The study included 200 patients, with a mean age of 51.32 years and 57.5% males.
• Mean RDW was 17.40%, with 57% 30-day mortality.
• RDW demonstrated a hierarchical association with 30-day mortality across the three RDW groups.
• APACHE II score, serum albumin, PaO2/FiO2 ratio, and fibrinogen were independent predictors of mortality.

Conclusions:

• Red cell distribution width (RDW) shows a graded relationship with 30-day mortality in severe sepsis.
• RDW is not an independent predictor of 30-day mortality in severe sepsis patients.
• Other factors like APACHE II score and serum markers are independent predictors.