Red Cell Distribution Width Is Independently Associated with Mortality in Sepsis

Area of Science:

• Critical Care Medicine
• Hematology
• Clinical Pathology

Background:

• Sepsis continues to be a leading cause of mortality.
• Previous small-scale studies indicated a correlation between red cell distribution width (RDW) and sepsis-related mortality.
• This study aimed to validate the association between RDW and mortality in a large, multicenter sepsis cohort.

Purpose of the Study:

• To validate the association between red cell distribution width (RDW) and mortality in a large multicenter cohort of septic patients.
• To determine an optimal cutoff value for RDW in predicting hospital mortality among sepsis patients.
• To compare the diagnostic performance of RDW with established scoring systems like SOFA and APACHE IV.

Main Methods:

• Retrospective analysis of 16,423 septic patients from the eICU Collaborative Research Database.
• Patients were categorized into low (≤15%) and high (>15%) RDW groups.
• Multivariable multilevel logistic regression models were used to assess the association between RDW and hospital/ICU mortality, with optimal cutoffs determined by the Youden index.

Main Results:

• Patients with high RDW were older and had higher APACHE IV scores.
• Both hospital and ICU mortality were significantly associated with RDW as a continuous variable.
• High RDW was linked to substantially higher hospital mortality (20% vs. 9%), with an adjusted odds ratio of 2.14.
• The optimal RDW cutoff for predicting hospital mortality was identified as 16%.

Conclusions:

• An association exists between elevated red cell distribution width (RDW) and increased mortality in sepsis patients.
• RDW serves as a valuable tool for risk stratification in sepsis, with an optimal cutoff of 16% for hospital mortality prediction.
• In conjunction with lactate, RDW demonstrates diagnostic performance comparable to SOFA and APACHE IV scores for sepsis outcomes.