Evaluation of red cell distribution width as a septic marker in comparison with clinical scores, C-reactive protein, and procalcitonin levels

IntroductionRed cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.MethodsAn observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.ResultsA total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.ConclusionsIn children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.

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Hubungan antara Nilai C−Reactive Protein, Immature To Total Neutrophil Ratio, dan Red Cell Distribution Width dengan Kejadian Sepsis Neonatorum Bayi Prematur

Sari Pediatri ◽

10.14238/sp21.4.2019.218-25 ◽

2020 ◽

Vol 21 (4) ◽

pp. 218

Author(s):

Fouad Hakiem ◽

Susi Susanah ◽

Tetty Yuniati

Keyword(s):

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

C Reactive Protein ◽

Distribution Width ◽

Reactive Protein

Latar belakang. Bayi prematur rentan terhadap infeksi yang berisiko sepsis akibat sistem imun yang belum sempurna. Deteksi dini sepsis neonatorum dapat dilakukan dengan menggunakan sistem penilaian modifikasi Tollner yang berdasarkan penilaian klinis dan parameter laboratorium, seperti C-Reactive Protein (CRP), rasio Immature to Total Neutrophil (rasio I/T), dan Red Cell Distribution Width (RDW). Pemeriksaan RDW menunjukkan heterogenitas eritrosit akibat detruksi eritrosit oleh suatu proses infeksi.Tujuan. Mengetahui hubungan antara nilai CRP, rasio I/T, dan RDW dengan kejadian sepsis neonatorum bayi prematur. Metode. Studi kasus kontrol menggunakan data sekunder rekam medis dengan subjek penelitian bayi prematur usia gestasi 28-<37 minggu yang dirawat di ruang neonatus Rumah Sakit Hasan Sadikin (RSHS) periode Desember 2018−Mei 2019. Kelompok kasus adalah bayi prematur sepsis, sedangkan kelompok kontrol adalah bayi prematur sakit tidak sepsis yang dilakukan pemeriksaan CRP, rasio I/T, dan RDW. Data dianalisis secara bivariat dan multivariat dengan regresi logistik menggunakan program SPSS dan STATA.Hasil. Penelitian ini melibatkan 30 bayi prematur sepsis dan 30 bayi prematur tidak sakit (kontrol). Analisis bivariat menunjukkan nilai CRP dan rasio IT berhubungan bermakna terhadap kejadian sepsis dengan masing-masing p<0,001 dan p<0,011. Analisis multivariat dengan regresi logistik menunjukkan nilai CRP >0,64 mg/dL berisiko 32 kali terhadap kejadian sepsis (p<0,001) dibandingkan rasio I/T >0,119 dan RDW >18,7% yang masing-masing 3,2 kali (p=0,446) dan 0,9 kali (p=0,947) terhadap kejadian sepsis.Kesimpulan. Pemeriksaan CRP merupakan pemeriksaan yang lebih baik dalam membantu menegakkan diagnosis sepsis neonatorum bayi prematur dibandingkan pemeriksaan rasio I/T dan RDW.

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Elevated Plasma Levels of B-Type Natriuretic Peptide but Not C-Reactive Protein Are Associated With Higher Red Cell Distribution Width in Patients With Coronary Artery Disease

International Heart Journal ◽

10.1536/ihj.50.301 ◽

2009 ◽

Vol 50 (3) ◽

pp. 301-312 ◽

Cited By ~ 59

Author(s):

Hidekatsu Fukuta ◽

Nobuyuki Ohte ◽

Seiji Mukai ◽

Tomoaki Saeki ◽

Kaoru Asada ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Plasma Levels ◽

Red Cell ◽

Cell Distribution ◽

Elevated Plasma ◽

C Reactive Protein ◽

Distribution Width ◽

Reactive Protein ◽

Artery Disease

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Diagnostic Performance of Red Cell Distribution Width in Adult Iraqi Patients with Ankylosing Spondylitis

Arthritis ◽

10.1155/2018/2904694 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Faiq I. Gorial ◽

Ali M. Hassan

Keyword(s):

Ankylosing Spondylitis ◽

Disease Activity ◽

Complete Blood Count ◽

Activity Index ◽

Disease Activity Index ◽

Red Cell ◽

Cell Distribution ◽

C Reactive Protein ◽

Distribution Width ◽

Reactive Protein

Background. Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease that leads to structural damage, functional impairment, and decrease in the quality of life. Red cell distribution width (RDW) is a part of the complete blood count (CBC) and estimates erythrocyte variability. Objective. To analyse RDW in patients with AS and to evaluate the relationships with acute phase reactants (APRs) and disease activity index. Patients and Methods. A total of 100 patients with AS (78 males and 22 females) were diagnosed according to the modified New York classification criteria for AS and 146 (99 males: 47 females) healthy individuals matched in age and sex as controls enrolled in the study. Demographic data, disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), medical history, C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), and complete blood count (CBC) were measured. Results. The mean age for patients and controls was 38.0 ± 9.0 and 35.8 ± 9.0 years, respectively (p=0.057). RDW was significantly higher in patients with AS compared with controls (14.133 ± 1.613 versus 12.299 ± 1.031, p < 0.001). There was a direct correlation of RDW with both ESR and CRP (P < 0.001); RDW had r=0.38 for C-reactive protein (CRP) and r=0.413 for ESR. Also BASDAI was directly correlated with RDW (r=0.326 p<0.001). RDW was a valid measure to differentiate between patients with AS and controls (AUC=0,84, p<0.001) and at optimum cut-off value>13% has highest accuracy (78.9%) with very good sensitivity test (81%) and NPV (85.6%) as well as good specificity (77.4%) and PPV (71.1%). Conclusion. RDW was higher in AS patients compared with controls and was directly correlated with ESR, CRP, and BASDAI. RDW was a valid simple measure with good accuracy to differentiate between patients with AS and controls.

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