scholarly journals The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal.

2020 ◽  
Author(s):  
Rajan Ghimire ◽  
Yogendra Man Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Likelihood Ratio ◽  
Apache Ii ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Very High

Abstract Background : Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has a number of variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis. Method: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Result: RDW is more efficacious test to predict mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) than APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW subgroup analysis showed no mortality in low RDW (<13.1) subgroup, 3.6% mortality in moderate (13.1 to 14) RDW group, 22.0% mortality in high (14 to >15.6) RDW group and 45.9% mortality in very high (>15.6) RDW group. Significant mortality difference was seen in high and very high RDW subgroups with a p-value of 0.003 and 0.008 respectively. Conclusion: RDW can be used as a good prognostic score to predict the mortality of patients with sepsis in the emergency room. RDW is a more efficacious test to predict mortality in sepsis than APACHE II or SOFA scores. Keywords : red cell distribution width, sepsis, emergency care, mortality

scholarly journals The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal

2020 ◽  
Author(s):  
Rajan Ghimire ◽  
Yogendra Man Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Likelihood Ratio ◽  
Area Under The Curve ◽  
Apache Ii ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Abstract Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis.Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively.Conclusion: Area under the curve value for RDW is fair enough to predict the mortality of patients with sepsis in the emergency room. It can be integrated with other severity scores (APACHE II or SOFA score) for better prediction of prognosis of septic patients.

scholarly journals The Utility of Red Cell Distribution Width to Predict Mortality of Septic Patients in Tertiary Hospital of Nepal

2019 ◽  
Author(s):  
Rajan Ghimire ◽  
Yogendra Man Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Likelihood Ratio ◽  
Prognostic Score ◽  
Apache Ii ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Very High

Abstract Background Sepsis is common problem encountered in emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency room using present scores which has numbers of variables to calculate. Red cell distribution width (RDW) is easy, cheap and efficacious score to predict severity and mortality of patients with sepsis. Method This prospective analytical study was conducted in emergency room of Tribhuvan University Teaching Hospital among patients of age ≥16 years with clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in study by using nonprobability purposive sampling method. Result RDW is more efficacious test to predict mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818) than APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770). Cutoff of RDW 15.05 has sensitivity of 73% (positive likelihood ratio 1.82) and specificity of 60% (negative likelihood ratio 0.45) while cutoff of RDW 16.1 has Sensitivity of 56% (PLR 2.07) and specificity of 73% (NLR 0.6). Out of 44 patients with septic shock 16 died (36.4%) and among 104 patients without septic shock,24 died (22.9%) with odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW subgroup analysis showed no mortality in low RDW (<13.1) subgroup, 3.6% mortality in moderate (13.1 to 14) RDW group, 22.0% mortality in high (14 to >15.6) RDW group and 45.9% mortality in very high (>15.6) RDW group. Significant mortality difference seen in high and very high RDW subgroup with p value 0.003 and 0.008 respectively. Conclusion RDW is more efficacious test to predict mortality in sepsis than APACHE II or SOFA. Cutoff of RDW 15.05 has sensitivity of 73% and specificity of 60%. So RDW can be used as a good prognostic score to predict severity and mortality of patients with sepsis in emergency room.

scholarly journals The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal

2020 ◽  
Author(s):  
Rajan Ghimire ◽  
Yogendra Man Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Likelihood Ratio ◽  
Area Under The Curve ◽  
Apache Ii ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Abstract Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis.Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively.Conclusion: Area under the curve value for RDW is fair enough to predict the mortality of patients with sepsis in the emergency room. It can be integrated with other severity scores (APACHE II or SOFA score) for better prediction of prognosis of septic patients.

scholarly journals The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal.

2020 ◽  
Author(s):  
Rajan Ghimire ◽  
Yogendra Man Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Likelihood Ratio ◽  
Area Under The Curve ◽  
Red Cell Distribution Width ◽  
Youden Index ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Abstract Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis. Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively. Conclusion: Area under the curve value for RDW is fair enough to use it as a good prognostic score to predict the mortality of patients with sepsis in the emergency room. Keywords: red cell distribution width, sepsis, emergency care, mortality

scholarly journals Red cell distribution width as a diagnostic marker in neonatal sepsis

2020 ◽  
Vol 7 (4) ◽  
pp. 820
Author(s):  
Anupama Deka ◽  
Aravind P.
Keyword(s):  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Statistical Significance ◽  
Neonatal Morbidity ◽  
Red Cell Distribution Width ◽  
Sepsis Group ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Background: The early diagnosis of neonatal sepsis, a significant cause of neonatal morbidity and mortality still remains a challenge. Red-cell Distribution Width (RDW) vary significantly in conditions associated with inflammation and infection like sepsis. The study aims to find the normal range of RDW in healthy newborns and investigate the role of RDW in the early diagnosis of neonatal sepsis.Methods: This is a prospective observational study, 50 normal and 50 sepsis neonates were considered for the study. The neonatal sepsis group consisted of neonates with (i) Positive sepsis screen with/without clinical features of neonatal sepsis and/or (ii) Blood, urine or CSF culture positive or signs of pneumonia on chest x-ray. The mean RDW and the relationship between RDW and neonatal sepsis were analysed using appropriate statistical methods in SPSS-25 software.Results: Mean RDW (%) was significantly higher in sepsis neonates (18.59±1.28) than in normal newborns (16.21±1.35). RDW had statistical significance with CRP (C-Reactive Protein) in the sepsis group. RDW had significant relationship with the diagnosis of neonatal sepsis with a p value of 0.000. An RDW cut-off level of 17.25% had 86% sensitivity, 87% specificity, and 93.5% accuracy in diagnosing neonatal sepsis.Conclusions: RDW helps as a diagnostic test in the early diagnosis of neonatal sepsis. 

Red cell distribution width is a predictor of mortality in patients with severe sepsis and septic shock

2013 ◽  
Vol 31 (6) ◽  
pp. 989-990 ◽  
Author(s):  
Sevket Balta ◽  
Sait Demirkol ◽  
Mustafa Hatipoglu, ◽  
Sukru Ardic ◽  
Zekeriya Arslan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Sepsis And Septic Shock

scholarly journals Study on red cell distribution width, haematocrit and red blood corpuscle (RBC) indices are early markers for the detection of coronary artery disease: a case control study.

2019 ◽  
Vol 26 (12) ◽  
pp. 2075-2079
Author(s):  
Shahzeb Rasool Memon ◽  
Gul Hassan Brohi ◽  
Fozia Rasool Memon ◽  
Muhammad Yaqoob Shahani ◽  
Samreen Memon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Rbc Indices ◽  
Artery Disease ◽  
Stable Cad

Cardiovascular disease and its complications are mainly causes of coronary artery disease (CAD). The distribution width of red blood cells (RDW) is a quantitative measurement of the variance in circulating erythrocyte size. Various research publications have shown that patients with previous history coronary artery disease having greater levels of Red cell distribution width are on risk of mortality and cardiovascular events. We tested the hypothesis that Red cell distribution width, Hct, and other red blood corpuscle (RBC) indices are associated with CAD. Hence, we measured RDW, Hct, and other RBC indices in AMI and stable CAD (SCAD) and compared them with age- and sex-matched controls. Objectives: To study the changes in Red cell distribution width and RBC indices in acute myocardial infarction (AMI) and SCAD and compare them with age- and sex-matched controls. Study Design: A comparative study. Setting: Department of Cardiology, Liaquat University Hospital. Period: 1st September 2013 to 28th February 2014. Material & Methods: 128 subjects (39 AMI patients, 24 SCAD patients and 65 controls). Venous samples from AMI subjects were collected in standardized ethylenediaminetetraacetic acid (EDTA) sample tubes on admission (within 6 h of chest pain). Using Sysmex KX21-N autoanalyzer, RDW and RBC indices were evaluated within 30 minutes of blood collection. Arterial blood samples were also obtained from stable CAD patients admitted to angiography and routine inspections. There has been no significant difference. Results: In total 128 patients, Mean ± SD of RDW patients with CAD was 14.12 ± 1.31%) as compared to controls (15.62 ± 6.51%) with insignificant difference (p value > 0.05). Mean ± SD of RDW patients with AMI was 14.36 ± 1.4% as compared to stable CAD (13.7 ± 1.09%) and controls (15.62 ± 6.51%) (p value > 0.05). Mean ± SD of RDW patients with Hct in patients with CAD was 43.16 ± 5% as compared to controls (41.9 ± 6.9%) with insignificant difference (p value > 0.05). Conclusions: There was no association between RWD, Hct, and other RBC indices with CAD, AMI, and stable CAD.

scholarly journals A CLINICAL STUDY TO FIND OUT THE RED CELL DISTRIBUTION WIDTH (RDW) CORRELATION WITH NEONATAL SEPSIS MORTALITY

2020 ◽  
Vol 8 (11) ◽  
pp. 175-178
Author(s):  
Sana Ibad Khan ◽  
◽  
Hiru Navaney ◽  
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Marker ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Medical Sciences ◽  
Distribution Width ◽  
Critical Patients ◽  
And Oxidative Stress

Introduction: In developing countries like India neonatal sepsis is a major cause of mortality . Red cell distribution width (RDW) reflect the degree of inflammation and oxidative stress .As RDW is a readily available pramater and recent studies found that it can taken as a marker of mortality in critical patients 1,2,.However, its role in neonates remains unexplored. Hence, the objective of the present study was to evaluate the association of RDW with neonatal sepsis and its role as a predictive marker for outcome in neonatal sepsis.3, 5 Aims And Objectives: To find out the predictive value of RDW in relation to neonatal sepsis. Materials And Method: Prospective observational study was carried out in a NICU of Saraswathi Institute Of Medical Sciences for a period of 1 year. RDW values of septic neonates are compared with controls .A total of 50 septic neonates and 50 controls were enrolled of same gestational age and weight.RDW values are arranged as above 50th percentile and below 50th percentile. The outcomes of two groups are assessed in relation with RDW. Result And Conclusion: RDW levels were higher among septic neonates as compared to controls with p value of <.001.High RDW is associated with neonatal sepsis and it can take as a marker for mortality associated with neonatal sepsis.

scholarly journals Red Cell Distribution Width as a Predictor of Severity of Acute Pancreatitis

2019 ◽  
Vol 17 (2) ◽  
pp. 43-46
Author(s):  
Pradip Thapa ◽  
Subodh Gautam ◽  
Hemanta Pun ◽  
Anup Sharma
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
College Teaching ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Medical College

Introduction: Acute pancreatitis (AP) is a disorder featured by local and systemic inflammatory response, which manifests as mild, self-limited disorder to severe and sometimes fatal disease. Red cell distribution width (RDW) is reflective of systemic inflammation and has been shown to be effective at predicting severity. This study was aimed to investigate the association between Red cell distribution width as coefficient of variation (RDW -CV) on admission and severity of acute pancreatitis. Method: This was a hospital based prospective study conducted in the Department of Surgery, Nepalgunj Medical College Teaching Hospital for a period of 2 years from July 2017 to June 2019. The patients with acute pancreatitis were categorized into mild, moderate and severe acute pancreatitis. The value of RDW-CV on admission was correlated with the severity of acute pancreatitis. Results: RDW-CV on admission was significantly correlated with the severity of AP (p value <0.001). Receiver Operating Characterstic (ROC) analysis showed that RDW has very good discriminative power for severe acute pancreatitis [AreaUnder curve (AUC) 0.963, 95% CI, 0.919 to 1.007, p-value <0.001] but not useful to predict mild AP (AUC 0.157, 95% CI, 0.063 to 0.250, p value 0.14) and moderate AP (AUC 0.397, 95% CI, 0.252 to 0.541, p value 0.234). The maximum sensitivity and specificity of detecting severe AP was 95.7% and 91.5% respectively. The positive predictive value (PPV) and negative predictive value (NPV) was 84.6% and 97.7% respectively. Conclusion: RDW-CV width on admission is a predictor of severity in patients with severe acute pancreatitis.

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