High red blood cell distribution width as a marker of hospital mortality after ICU discharge: a cohort study

Abstract Context Red blood cell distribution width (RDW) has been used to predict mortality during infection and inflammatory diseases. It also been purported to be predictive of mortality following traumatic injury. Objective To identify the role of RDW in predicting mortality in trauma patients. We also sought to identify the role of RDW in predicting the development of sepsis in trauma patients. Methods A retrospective observational study was performed of the medical records for all adult trauma patients admitted to Loyola University Medical Center from 2007 to 2014. Patients admitted for fewer than four days were excluded. Admission, peak, and change from admission to peak (Δ) RDW were recorded to determine the relationship with in-hospital mortality. Patient age, development of sepsis during the hospitalization, admission to the intensive care unit (ICU), and discharge disposition were also examined. Results A total of 9,845 patients were admitted to the trauma service between 2007 and 2014, and a total of 2,512 (25.5%) patients fit the inclusion criteria and had both admission and peak values available. One-hundred twenty (4.6%) died while in the hospital. RDW values for all patients were (mean [standard deviation, SD]): admission 14.09 (1.88), peak 15.09 (2.34), and Δ RDW 1.00 (1.44). Admission, peak, and Δ RDW were not significant predictors of mortality (all p>0.50; hazard ratio [HR], 1.01–1.03). However, trauma patients who eventually developed sepsis had significantly higher RDW values (admission RDW: 14.27 (2.02) sepsis vs. 13.98 (1.73) no sepsis, p<0.001; peak RDW: 15.95 (2.55) vs. 14.51 (1.97), p<0.001; Δ RDW: 1.68 (1.77) vs. 0.53 (0.91), p<0.001). Conclusion Admission, peak, and Δ RDW were not associated with in-hospital mortality in adult trauma patients with a length of stay (LOS) ≥four days. However, the development of sepsis in trauma patients is closely linked to increased RDW values and in-hospital mortality.

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Predictive value of red blood cell distribution width in critically ill patients with atrial fibrillation: a retrospective cohort study

Annals of Palliative Medicine ◽

10.21037/apm-20-1704 ◽

2021 ◽

Vol 10 (1) ◽

pp. 58-58

Author(s):

Hongfen Zeng ◽

Tingting Tao ◽

Zetao Ma ◽

Min Wang ◽

Xue Lu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Blood Cell ◽

Red Blood Cell ◽

Retrospective Cohort Study ◽

Critically Ill Patients ◽

Retrospective Cohort ◽

Cell Distribution ◽

Distribution Width ◽

Red Blood Cell Distribution

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Red Blood Cell Distribution Width in Hospitalized COVID-19 Patients

Frontiers in Medicine ◽

10.3389/fmed.2021.582403 ◽

2022 ◽

Vol 8 ◽

Author(s):

Preethi Ramachandran ◽

Mahesh Gajendran ◽

Abhilash Perisetti ◽

Karim Osama Elkholy ◽

Abhishek Chakraborti ◽

...

Keyword(s):

Septic Shock ◽

Mechanical Ventilation ◽

Blood Cell ◽

Hospital Mortality ◽

Red Blood Cell ◽

Morbidity And Mortality ◽

Cell Distribution ◽

Distribution Width ◽

Increased Risk ◽

Red Blood Cell Distribution

Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases.Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19.Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes.Results: A total of 294 COVID-19 patients were finally studied. Overall prevalence of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.6; 95%CI, 1.5-14.6) and septic shock (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia, ferritin, lactate, and absolute lymphocyte count. The association remained unchanged even after adjusting for other clinical confounders such as age, sex, body mass index, coronary artery disease, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. No association was found instead with mechanical ventilation and median LOS.Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock.

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