scholarly journals High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients

2020 ◽  
Vol 40 (3) ◽  
pp. 210-216
Author(s):  
Eva Gauchan ◽  
Sahisnuta Basnet
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Prognostic Indicator ◽  
Red Cell Distribution Width ◽  
Receiver Operating Curve ◽  
Critically Ill Children ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Complicated Course

Introduction: Red cell distribution width (RDW) is a frequently overlooked parameter in routine haematological reports. It is a simple and inexpensive test which has been found by many adult studies to be a prognostic indicator of mortality in intensive care units. The objective of this study was to see if high RDW could be used as a marker to predict mortality in critically ill children. Methods: This was a prospective observational study conducted in the paediatric intensive care unit (PICU) of a tertiary hospital of Western Nepal over a period of one year. Study subjects were selected by purposive sampling method. RDW at admission and relative change in RDW (ΔRDW) was compared to see if they had any role in predicting mortality in this group of children. Receiver operating curve analysis was plotted to find an optimal cut-off point to define high and low RDW and various outcome parameters were analysed. Results: Out of 131 children, there were 12 (9.1%) mortalities. Admission RDW was higher in the death group as compared to the survivor group (17 vs 14.6; p = 0.012). Similar finding was seen with ΔRDW (0.45 vs 0.00; p = 0.006). ΔRDW above the cut-off value of 0.15 was found to be associated with a generally more complicated course during hospitalisation as well as had more risk of mortality. Conclusions: Both RDW and ΔRDW above the cut-off value were found to be associated with mortality. In addition, high ΔRDW was also found to predict a more complicated course during hospitalisation.

scholarly journals Red cell distribution width as a prognostic marker in mechanically ventilated children admitted in pediatric critical care unit of tertiary care centre, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1794
Author(s):  
Swati M. Gadappa ◽  
Manas Kumar Behera
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Critically Ill ◽  
Red Cell Distribution Width ◽  
Critically Ill Children ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Mechanically Ventilated ◽  
Prospective Longitudinal

Background: Paediatric population is a vulnerable group necessitating standard care for medically and surgically ill children. Red cell distribution width (RDW) is a simple and low-cost measure that denotes the variability in red blood cell size. Any process that releases reticulocytes in the circulation will result in an increase in RDW. RDW may also be useful as a biomarker of disease severity and clinical outcomes in critically ill patients. Methods: Retrospective cohort study of all patients between 1month-12yrs of age, mechanically ventilated in Paediatric intensive care unit. Those patients with RDW on admission and complete data for PIM3 (Paediatric Index of Mortality 3) were included. Analyses included correlation, logistic regression analysis, and receiver operating characteristic (ROC) curves.Results: Retrospective analysis of data on 93 consecutive critically ill children admitted in PICU was done between Jan 2015- June 2016. We noted statistically significant correlation between mortality and anemia (10.24 g/dL, SD 2.26; 8.78 g/dL, SD 2.60.p = 0.009), LOS on MV (p = 0.008), RDW (p = 0.002), shock (p = 0.004) and ventilator associated Pneumonia (p = 0.024).  Mortality increased as length of stay on mechanical ventilation increased (4.13 days, SD 2.125 versus 6.94 days, SD 7.603 p = 0.008). The cut-off of 18.10 was chosen as Mean RDW. Based on AUROC, RDW is independently associated with high risk of mortality.Conclusions: RDW measured within 24 hours of PICU admission was independently associated with length of stay on mechanical ventilation and mortality in a general PICU population. We recommend the need for multicentric, prospective longitudinal studies to determine the optimum utility of RDW to enhance decision making in PICU.

scholarly journals Clinical Usefulness of Red Cell Distribution Width/Albumin Ratio to Discriminate 28-Day Mortality in Critically Ill Patients with Pneumonia Receiving Invasive Mechanical Ventilation, Compared with Lacate/Albumin Ratio: A Retrospective Cohort Study

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2344
Author(s):  
Jong Hwan Jeong ◽  
Manbong Heo ◽  
Seung Jun Lee ◽  
Yi Yeong Jeong ◽  
Jong Deog Lee ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Red Cell Distribution Width ◽  
Receiver Operating Curve ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Albumin Ratio

The value of the red cell distribution width (RDW) is associated with prognosis in critically ill patients. A simplex combined index—the RDW/albumin ratio—has been proposed for the prediction of mortality, as has the lactate/albumin ratio. The aim of this study was to evaluate the clinical utility of the RDW/albumin ratio regarding 28-day mortality in critically ill patients with pneumonia. Clinical data of critically ill patients with pneumonia who were hospitalized in the medical intensive care unit from May 2018 to December 2020, and received invasive mechanical ventilation (IMV), were reviewed retrospectively. The values of RDW, lactate, and albumin measured at the time of IMV, were used for the index calculations. Of the 234 patients, the median age was 76 years, and 74.2% were male. The 28-day mortality rate was 47.3%. The median RDW/albumin ratio was significantly higher in non-survivors than survivors at 28 days (5.8 vs. 4.9, p < 0.001). A higher RDW/albumin ratio was significantly associated with increased 28-day mortality (odds ratio [OR] 1.338, 95% confidence interval [CI] 1.094–1.637, p = 0.005). The area under the receiver operating curve (AUROC) was 0.694 (95% CI: 0.630–758, p < 0.005) to discern 28-day mortality without significant difference, compared with that of the lactate/albumin ratio. Our data suggest that high RDW/albumin ratio has a similar predictability to the lactate/albumin ratio in critically ill patients with pneumonia receiving IMV.

A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

2021 ◽  
Author(s):  
Devin Murphy ◽  
Etan Orgel ◽  
Wouter Koek ◽  
Melissa Frei-Jones ◽  
Christopher Denton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Critically Ill ◽  
Meta Analysis ◽  
Red Cell Distribution Width ◽  
Critically Ill Children ◽  
Red Cell ◽  
Cell Distribution ◽  
Pediatric Critical Care ◽  
Distribution Width

AbstractRed cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.

Outcome Prediction Value of Red Cell Distribution Width in Critically-ill Children

2018 ◽  
Vol 55 (5) ◽  
pp. 414-416 ◽  
Author(s):  
Anil Sachdev ◽  
Ashish Simalti ◽  
Anil Kumar ◽  
Neeraj Gupta ◽  
Dhiren Gupta ◽  
...  
Keyword(s):  
Critically Ill ◽  
Outcome Prediction ◽  
Red Cell Distribution Width ◽  
Critically Ill Children ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

The Red Cell Distribution Width as a Prognostic Indicator in Idiopathic Pulmonary Fibrosis

CHEST Journal ◽  
2013 ◽  
Vol 143 (6) ◽  
pp. 1692-1698 ◽  
Author(s):  
Steven D. Nathan ◽  
Taylor Reffett ◽  
A. Whitney Brown ◽  
Chelsea P. Fischer ◽  
Oksana A. Shlobin ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Prognostic Indicator ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

scholarly journals Red cell distribution width and all-cause mortality in critically ill patients*

2011 ◽  
Vol 39 (8) ◽  
pp. 1913-1921 ◽  
Author(s):  
Heidi S. Bazick ◽  
Domingo Chang ◽  
Karthik Mahadevappa ◽  
Fiona K. Gibbons ◽  
Kenneth B. Christopher
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
All Cause Mortality

scholarly journals Red cell distribution width (RDW): a prognostic indicator of severe COVID-19

2020 ◽  
Vol 8 (19) ◽  
pp. 1230-1230
Author(s):  
Changzheng Wang ◽  
Hongmei Zhang ◽  
Xiaocui Cao ◽  
Rongrong Deng ◽  
Yi Ye ◽  
...  
Keyword(s):  
Prognostic Indicator ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

scholarly journals A study on the predictive value of red blood cell distribution width as a biomarker of outcome in paediatric critical illness

2020 ◽  
Vol 7 (12) ◽  
pp. 2347
Author(s):  
Sudha Rudrappa ◽  
Meghana Narasimhegowda ◽  
Girish Gopal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Cell ◽  
Critically Ill ◽  
Red Blood Cell ◽  
Paediatric Population ◽  
Critically Ill Children ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

Background: Red blood cell distribution width (RDW) is a simple, low cost measure, which is routinely reported as a standard component of complete hemogram. Several recent studies have found a positive association between RDW and risk of both morbidity and mortality in several diseases, particularly in critically ill adults.But, data regarding the outcome predictive utility of RDW in critically ill paediatric population is limited. The objective of the study was to determine the association between RDW and mortality and morbidity in paediatric critical illness.Methods: A cross sectional observational study was conducted from February 2019-May 2019 at Cheluvamba Hospital, Mysuru. 97 subjects admitted to Paediatric intensive care unit (PICU) were included in the study. Data regarding subject demographics, hospitalization characteristics, laboratory values and outcomes were collected.Results: A significant positive correlation was found between mortality among critically ill children and RDW measured within 24 hours of PICU admission (p=0.01) and peak RDW during the first 7 days of PICU stay (p=0.01). The relative change in RDW correlated significantly (p=0.01) with the number of intensive care unit (ICU) free days. Our subjects were divided into quartiles based on the admission RDW, subjects in the fourth quartile were found to have the highest mean Paediatric risk of mortality (PRISM III) score, Paediatric index of mortality (PIM 2) score and the least number of ICU free days. Area under the receiver operator curve (AUROC) for incidence of death was 0.706 for admission RDW,0.71 for peak RDW and 0.882 for PIM 2 score.Conclusions: Our data demonstrates that RDW at the time of PICU admission could serve as a cost-effective marker for early identification of critically ill paediatric population who are at risk for adverse outcomes.

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