The correlation between prognosis and red cell distribution width in sepsis patients

Abstract

Objective To investigate the correlation between 28-day prognosis and red cell distribution width (RDW) in sepsis patients. Methods This was a prospective observational study. Two hundred and thirteen sepsis patients were consecutively selected, and the patients were divided into 2 groups according to RDW: normal RDW group (RDW <0.15, 160 cases) and high RDW group (RDW≥0.15, 53 cases). The general conditions, acute physiology and chronic health evaluation (APACHE) Ⅱ score, sequential organ failure assessment (SOFA), hypersensitive C reactive protein (hs-CRP), procalcitonin (PCT), arterial blood lactic acid, liver function injury, renal function injury and 28-day mortality were compared between 2 groups. The independent risk factors of 28-day prognosis were analyzed by multifactor Logistic regression analysis. Kaplan-Meier survival analysis was used to draw the 28-day survival curve, and the survival rate was compared between 2 groups by log-rank test. Results The 28-day mortality in high RDW group (35.8%, 19/53) was significantly higher than that in normal RDW group (17.5%, 28/160), and there was statistical difference (P =0.007). RDW ≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.634, 95% CI 1.316-5.273,P =0.006). After adjusted by gender, age and other relative factors, RDW≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.895, 95% CI 1.155-7.252,P=0.023). The 28-day accumulative survival rate in high RDW group was significantly lower than that in normal RDW group (50.5% vs. 63.0%), and there was statistical difference (P =0.014). Conclusion The high RDW in sepsis patients is the independent risk factor of 28-day death, and RDW≥ 0.15 shows an important predictive value in the prognosis of sepsis patients. Key words: Sepsis; Prognosis; Prospective studies; Red cell distribution width