Red cell distribution width predicts new-onset atrial fibrillation in sepsis patients

Abstract

Background Sepsis is a major cause of mortality in non-cardiac intensive care units, and ranks 10th among causes of death overall. Acute new onset atrial fibrillation is a common observation in critically ill patients admitted with sepsis, there is a direct relationship with disease severity. The red cell distribution width variations reflects a range of systemic diseases including heart failure, stable coronary disease, acute coronary syndrome and stroke. Objectives In this study, we aimed to investigate the relation between red cell distribution width (RDW) and atrial fibrillation (AF) in critically-ill patients with sepsis. Settings and Design We retrospectively examined 70 sepsis patients (35 sepsis patients with newly developed AF during intensive care unit (ICU) stay and 35 sepsis patients without AF matched with age and sex. We investigated the predictive potential for atrial fibrillation for RDW, Ejection fraction, central venous pressure (CVP), Heart rate and qSofa score. Results The mean age of AF group was 54.49 ± 10.07 vs. 56.26 ± 11.766 for Non-AF group. Baseline Ejection fraction, systolic blood pressure, heart rate and CVP showed no significant differences. RDW on admission was significantly different between groups; 18.94 ± 1.126 (AF group) vs. 14.76 ± 0.97 (Non AF Group). ROC curve analysis was done on AF group to determine cut-off values for RDW. Cut-off point was at 17.6 with 97 % sensitivity and 60.7 % specificity. Conclusions RDW levels were higher in sepsis patients with newly developed atrial fibrillation. An increased RDW level in the patient with sepsis may alert physician on developing or presence of atrial fibrillation.