Correlation of the changing trends of red cell distribution width and serum lactate as a prognostic factor in sepsis and septic shock

Background: The ratio of hemoglobin to red cell distribution width (HRR) has been described as an effective prognostic factor in several types of cancer. The aim of this study was to investigate the prognostic role of preoperative HRR in resected-lung-adenocarcinoma patients. Methods: We enrolled 342 consecutive patients. Age, sex, surgical resection, adjuvant treatments, pathological stage, preoperative hemoglobin, red cell distribution width, and their ratio were recorded for each patient. Results: Mean age was 66 years (SD: 9.0). There were 163 females (47.1%); 169 patients (49.4%) had tumors at stage I, 71 (20.8%) at stage II, and 102 (29.8%) at stage III. In total, 318 patients (93.0%) underwent lobectomy, and 24 (7.0%) pneumonectomy. Disease-free survival multivariable analysis disclosed an increased hazard ratio (HR) of relapse for preoperative HRR lower than 1.01 (HR = 2.20, 95%CI: (1.30–3.72), p = 0.004), as well as for N1 single-node (HR = 2.55, 95%CI: (1.33–4.90), p = 0.005) and multiple-level lymph node involvement compared to N0 for both N1 (HR = 9.16, 95%CI:(3.65–23.0), p < 0.001) and N2 (HR = 10.5, 95%CI:(3.44–32.2, p < 0.001). Conclusion: Pre-operative HRR is an effective prognostic factor of disease-free survival in resected-lung-adenocarcinoma patients, together with the level of pathologic node involvement.

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Dynamic Change of Red Cell Distribution Width Levels in Prediction of Hospital Mortality in Chinese Elderly Patients with Septic Shock

Chinese Medical Journal ◽

10.4103/0366-6999.205858 ◽

2017 ◽

Vol 130 (10) ◽

pp. 1189-1195 ◽

Cited By ~ 3

Author(s):

Xue-Feng Ju ◽

Fei Wang ◽

Li Wang ◽

Xiao Wu ◽

Ting-Ting Jiang ◽

...

Keyword(s):

Septic Shock ◽

Elderly Patients ◽

Hospital Mortality ◽

Dynamic Change ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Chinese Elderly ◽

Distribution Width

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

10.21203/rs.2.10110/v5 ◽

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.

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Correlation of red cell distribution width and serum lactate levels in critically ill pediatric patients

Bali Journal of Anesthesiology ◽

10.4103/bjoa.bjoa_28_20 ◽

2020 ◽

Vol 4 (3) ◽

pp. 104

Author(s):

INyoman Budi Hartawan ◽

NiMade Sukewanti ◽

DyahKanya Wati ◽

IdaBagus Gede Suparyatha ◽

Christopher Ryalino

Keyword(s):

Critically Ill ◽

Pediatric Patients ◽

Serum Lactate ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Lactate Levels

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

10.21203/rs.2.10110/v1 ◽

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.

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