J Korean Soc Emerg Med.  2017 Jun;28(3):255-262. 10.0000/jksem.2017.28.3.255.

Efficacy of Red Cell Distribution Width as Prognostic Factor for Sepsis-3 Patients in Emergency Department

• Lee S
• Hong DY
• Kim JW
• Kim SY
• Park SO
• Lee KR
• Baek KJ
• Kim JY

• KMID: 2386577
• DOI: http://doi.org/10.0000/jksem.2017.28.3.255

Abstract

PURPOSE
Red cell distribution width (RDW) was introduced as a new biomarker for the prognosis of sepsis patients. In addition, the definition of sepsis has changed recently to sepsis-3 criteria. The aim of this study was to compare the efficacy of RDW as a prognostic factor for sepsis-3 patients in the emergency department.
METHODS
We conducted a retrospective study of patients who were suspected of having sepsis between October, 2015 and April, 2016. The demographic data, comorbidities, blood test results, including RDW, lactate, C-reactive protein, and procalcitonin at admission, as well as the Mortality in Emergency Department Sepsis score were compared between the 30-day survivors and nonsurvivors. Analysis compared the areas under the receiver operator characteristic curves for 30-day mortality. Multivariate Cox proportional hazards regression analysis was performed to determine the risk factors for mortality.
RESULTS
A total of 222 patients were included. The mean age was 75, 51.8% of the patient population was male, and the overall mortality rate was 16.7%. The non-survival group had higher RDW levels than the survivor group (14.5% vs 13.4%). The area under the receiver operating characteristic curve of RDW to predict mortality was 0.724. In a Cox proportional hazards analysis, RDW had 1.292 hazard ratio. Setting the RDW cutoff value to 14.3, we found that sensitivity and specificity of predicting mortality was 75.1% and 70.3%, respectively.
CONCLUSION
It may be possible to use RDW to predict mortality in sepsis-3 patients.

Keyword

Sepsis; Red blood cell; Prognosis; Mortality; Emergency departments

MeSH Terms

C-Reactive Protein
Comorbidity
Emergencies*
Emergency Service, Hospital*
Erythrocyte Indices*
Erythrocytes
Hematologic Tests
Humans
Lactic Acid
Male
Mortality
Prognosis
Retrospective Studies
Risk Factors
ROC Curve
Sensitivity and Specificity
Sepsis
Survivors
C-Reactive Protein
Lactic Acid