Dataset Information

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia.

ABSTRACT:

Objective

Red cell distribution width (RDW) is associated with mortality in patients with community-acquired pneumonia (CAP). However, little is known about the effect of changes in RDW during treatment on mortality. Thus, the objective of this study was to evaluate the association between RDW changes and mortality in hospitalized patients with CAP.

Methods

Retrospective analyses were performed using medical records of patients hospitalized for CAP from April 2008 to February 2014. The abstracted laboratory values included RDW (from days one to four), clinical variables, and pneumonia severity index (PSI) scores. The ?RDW_n-1 was defined as the change in RDW calculated as: (RDW_day1-RDW_day-n)/RDW_day1×100 (%), where 'day n' refers to hospital day.

Results

During the study period, a total of 1,069 patients were hospitalized for CAP. The 30-day mortality was 100/1,069 (9.4%). The median RDW at baseline was 14.1% (range, 11.1 to 30.2) and differed significantly between survivors and non-survivors (P<0.05). There were 470 patients with available serial RDW data (30-day mortality 58/470 [12.3%]). Of those, age, PSI score, blood urea nitrogen level, total protein concentration, albumin level, RDW at day 1, and the ?RDW_4-1 differed significantly between survivors and non-survivors. Multivariate Cox regression analysis showed that the significance of the relationship between ?RDW_4-1 and 30-day mortality risk remained after adjusting for age, PSI score, RDW at day 1, total protein concentration, and initial albumin level.

Conclusion

RDW change from day 1 to day 4 was an independent predictor of mortality in patients with CAP.

SUBMITTER: Lee SM

PROVIDER: S-EPMC5065335 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Publications

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia.

Lee Sang-Min SM Lee Jae Hyuk JH Kim Kyuseok K Jo You Hwan YH Lee Jungyoup J Kim Joonghee J Hwang Ji Eun JE Ko Young Sang YS Ha Chulmin C Jang Sujin S Park Hyunmi H

Clinical and experimental emergency medicine 20160930 3

<h4>Objective</h4>Red cell distribution width (RDW) is associated with mortality in patients with community-acquired pneumonia (CAP). However, little is known about the effect of changes in RDW during treatment on mortality. Thus, the objective of this study was to evaluate the association between RDW changes and mortality in hospitalized patients with CAP.<h4>Methods</h4>Retrospective analyses were performed using medical records of patients hospitalized for CAP from April 2008 to February 2014 ...[more]

PMID: 27752632

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Project description:BackgroundEpidemiological studies have demonstrated an association between red blood cell distribution width (RDW) and the prognosis of pneumonia-associated diseases. However, prognostic value of RDW in patients with ventilator-associated pneumonia (VAP) has yet to be investigated. This study aimed to explore the association between RDW and in-hospital mortality in VAP patients and explore predictive value of RDW for VAP patients.MethodsThis retrospective cohort study included 1,543 VAP patients from the Medical Information Mart for Intensive Care IV database 2008-2019. The primary outcome was considered to 30-day in-hospital mortality of VAP patients in this study. Non-high RDW level group was defined as <15 %, and high RDW level group as ≥15%. The possible confounding factors were screened by least absolute shrinkage and selection operator regression. Univariate and multivariate COX regression analyses were used for the assessment on the association of RDW and 30-day in-hospital mortality in VAP patients. We also performed subgroup analyses. Furthermore, a comparative analysis of RDW and sequential organ failure assessment (SOFA) score and simplified acute physiology score II (SAPS II) were performed by receiver operating characteristic (ROC) curves.ResultsThe 30-day in-hospital mortality of VAP patients was approximately 19.05%. After adjusting all confounding factors, high RDW was associated with 30-day in-hospital mortality among VAP patients by using non-high RDW as the reference [hazard ratio (HR) =1.29, 95% confidence interval (CI): 1.01-1.63]. Additionally, the relationship was also robust in several populations, such as patients were younger than 60 years, or had not a history of congestive heart failure, or had a history of sepsis, or had not received renal replacement therapy, or had a duration of mechanical ventilation for more than 7 days. The result of ROC indicated that RDW had a better prognostic value in predicting 30-day in-hospital mortality for VAP patients than SOFA score and SAPS II score.ConclusionHigh RDW level is associated with an increased 30-day in-hospital mortality. The RDW is a promising biomarker in predicting 30-day in-hospital mortality for patients admitted to the ICU, regardless of VAP.

Dataset Information

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia.

Objective

Methods

Results

Conclusion

Publications

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia.

Similar Datasets

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