Correlation Between Red Cell Distribution Width (RDW) and Sequential Organ Failure Assessment (SOFA) Score in Sepsis Patients

Abstract

Background: There are an estimated 31.5 million cases of sepsis per year, and approximately 61% end up in sepsis shock, with a potential mortality rate of 5.3 million per year. In addition to the sequential organ failure assessment (SOFA) score, several biomarkers have been used to assess severity and predict mortality, including red cell distribution width (RDW). RDW is increased in conditions of ineffective red blood cell production or destruction that occur in inflammation or infection. RDW above 15.5% is associated with rigid and indestructible red blood cells, which can impede microcirculation and contribute to organ dysfunction, a part of the SOFA score.Objective: The aim of this study was to determine the correlation between RDW and SOFA score in sepsis patients admitted to the intensive care unit (ICU) of Rumah Sakit Umum Pusat Haji Adam Malik Medan.Methods: This study used a cohort-prospective study design with a consecutive sampling technique of the population that met the inclusion criteria. The samples were sepsis patients who were admitted to the ICU of Rumah Sakit Umum Pusat Haji Adam Malik Medan in April–June 2023. The data was analyzed by a Pearson or Spearman analysis test.Result: There was a significant correlation between RDW and SOFA score (r = 0.471; p<0.05) in ICU sepsis patients. There was a significant correlation (p = 0.003) between RDW values and SOFA scores on the third day, where there was a moderate degree of correlation (r = 0.471), but there was no significant correlation (p = 0.103) between RDW values and SOFA scores on the first day. The sensitivity, specificity, and cut-off values of RDW were found to be 76.5%, 75%, and 14.75%, which compared to SOFA were 76.5%, 75%, and 10.5.Conclusion: There is a statistically significant relationship between RDW and SOFA, with a moderate correlation.