Red blood cell distribution width as mortality biomarker in patients with traumatic brain injury

One study found higher red blood cell distribution width (RDW) on the admission of traumatic brain injury (TBI) in non-surviving patients; however, a regression analysis was not carried out to establish an association between RDW and TBI mortality. Thus, the objectives of this study were to determine whether there is an association between RDW and TBI mortality, and to describe the temporal profile of RDW during the first week. Isolated (< 10 points in non-cranial aspects of Injury Severity Score) and severe (< 9 points in Glasgow Coma Scale) TBI patients were included. RDW at days 1, 4, and 8 of TBI were determined. The end-point study was 30-day mortality. Ninety-seven surviving patients compared to the 38 non-surviving patients had higher RDW at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p < 0.001). The area under the curve (95% CI) for prediction of mortality by RDW at days 1, 4, and 8 was 0.81 (0.73-0.87; p < 0.001), 0.92 (0.85-0.96; p < 0.001) and 0.94 (0.88-0.98; p < 0.001). Regression analysis showed an association between RDW and mortality (odds ratio = 1.778; 95% CI 1.312-2.409; p < 0.001). The association found between RDW on admission and mortality is the main new finding of our study. Regarding the temporal profile of RDW, the fact that RDW during the first week of TBI may help in estimating prognosis is another interesting finding of our study.