Related Experiment Video
Updated: Jul 16, 2026
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Admission Red Blood Cell Distribution Width and Mean Platelet Volume as Predictors of Mortality in the Pediatric
Kanokkarn Sunkonkit1,2,3, Chatree Chai-Adisaksopha2,3,4, Rungrote Natesirinilkul5
1Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Insights
Elevated red blood cell distribution width (RDW) and mean platelet volume (MPV) predict higher mortality in critically ill children. These accessible biomarkers can aid early risk assessment in pediatric intensive care units.
Area of Science:
- Pediatric critical care medicine
- Hematology
- Biomarker research
Background:
- Red blood cell distribution width (RDW) and mean platelet volume (MPV) are known prognostic indicators.
- Their predictive value for mortality in critically ill pediatric patients is not well-established.
Purpose of the Study:
- To investigate the association between RDW, MPV, and 28-day mortality in pediatric intensive care unit (PICU) patients.
- To evaluate RDW and MPV as potential biomarkers for risk stratification in this population.
Main Methods:
- Retrospective cohort study of 580 pediatric patients (1 month to 18 years) admitted to PICU for ≥24 hours.
- Log-binomial regression analysis was used to assess the association of RDW and MPV with 28-day mortality, adjusting for covariates.
- Covariates included age, sex, mechanical ventilation, vasoactive drug use, continuous renal replacement therapy, and multiorgan failure.
Main Results:
- The 28-day PICU mortality rate was 9.8%.
- Elevated RDW (≥15%) and MPV (≥10 fL) were independently associated with increased 28-day PICU mortality (aRR: 2.73 and 2.38, respectively).
- Both markers showed high negative predictive values (RDW: 96.0%, MPV: 94.6%).
Conclusions:
- Elevated RDW and MPV are independent predictors of increased 28-day mortality in critically ill pediatric patients.
- RDW and MPV show potential as accessible and cost-effective biomarkers for early risk stratification in PICU.
- Further research can validate these findings for clinical application in pediatric critical care.
Abstract:
Background/Objectives: Red blood cell distribution width (RDW) and mean platelet volume (MPV) are well-established prognostic biomarkers across various medical conditions. However, their role in predicting mortality among critically ill pediatric patients remains unclear. This study investigates the association between RDW, MPV, and 28-day mortality in pediatric intensive care unit (PICU) patients. Methods: This retrospective cohort study analyzed data from children aged 1 month to 18 years who were admitted to the PICUs at Chiang Mai University Hospital for ≥24 h between January 2018 and December 2022. The primary outcome was 28-day PICU mortality. A log-binomial regression analysis was conducted to assess the association of RDW and MPV with 28-day PICU mortality, adjusting for age, sex, mechanical ventilation, vasoactive drug use, continuous renal replacement therapy, and multiorgan failure. Results: A total of 580 PICU patients were included, 55.3% male, with a median age of 5.9 (IQR: 4.7-10.4) months. The 28-day PICU mortality rate was 9.8% (57/580). Respiratory failure and acute respiratory distress syndrome were the most common admission diagnoses (72.1%). Elevated RDW (≥15%) and MPV (≥10 fL) were independently associated with increased 28-day PICU mortality (adjusted RR: 2.73, 95% CI: 1.45-5.13 and 2.38, and 95% CI: 1.43-3.93, respectively). Both markers demonstrated high negative predictive values (RDW: 96.0% and MPV: 94.6%). Conclusions: Elevated RDW (≥15%) and MPV (≥10 fL) were independently associated with increased 28-day PICU mortality. These findings highlight their potential utility as accessible and cost-effective biomarkers for early risk stratification in critically ill pediatric patients.
