Red blood cell distribution width is associated with mortality in elderly patients with sepsis

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5 Citations (Scopus)

Abstract

Introduction: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. Methods: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥. 65. years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. Results: A total of 117 patients was included with mean age 81.5. ±. 8.3. years old. The mean APACHE II score was 21.9. ±. 7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1% increase in RDW, p = 0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95% confidence interval [CI]: 0.52-0.74, p = 0.025). In subgroup analysis, for qSOFA <. 2, nonsurvivors had higher RDW levels than survivors (17.0. ±. 3.3 vs. 15.3. ±. 1.4%, p = 0.044). Conclusions: In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <. 2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.

Original languageEnglish
JournalAmerican Journal of Emergency Medicine
DOIs
Publication statusPublished - 2018

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Erythrocyte Indices
Sepsis
Erythrocytes
Mortality
APACHE
Intensive Care Units
Survivors
Hospital Emergency Service
Decision Support Techniques
Septic Shock
Hospital Mortality
Proportional Hazards Models
Malnutrition
Biochemistry
Area Under Curve
Comorbidity
Cohort Studies
Cardiovascular Diseases
Retrospective Studies
Biomarkers

Keywords

  • Aged
  • Red blood cell distribution width
  • Sepsis

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

@article{37cf0a9c01854cfba62f5d4208d2b2bc,
title = "Red blood cell distribution width is associated with mortality in elderly patients with sepsis",
abstract = "Introduction: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. Methods: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥. 65. years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. Results: A total of 117 patients was included with mean age 81.5. ±. 8.3. years old. The mean APACHE II score was 21.9. ±. 7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1{\%} increase in RDW, p = 0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95{\%} confidence interval [CI]: 0.52-0.74, p = 0.025). In subgroup analysis, for qSOFA <. 2, nonsurvivors had higher RDW levels than survivors (17.0. ±. 3.3 vs. 15.3. ±. 1.4{\%}, p = 0.044). Conclusions: In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <. 2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.",
keywords = "Aged, Red blood cell distribution width, Sepsis",
author = "Wang, {An Yi} and Ma, {Hon Ping} and Kao, {Wei Fong} and Tsai, {Shin Han} and Chang, {Cheng Kuei}",
year = "2018",
doi = "10.1016/j.ajem.2017.10.056",
language = "English",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders",

}

TY - JOUR

T1 - Red blood cell distribution width is associated with mortality in elderly patients with sepsis

AU - Wang, An Yi

AU - Ma, Hon Ping

AU - Kao, Wei Fong

AU - Tsai, Shin Han

AU - Chang, Cheng Kuei

PY - 2018

Y1 - 2018

N2 - Introduction: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. Methods: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥. 65. years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. Results: A total of 117 patients was included with mean age 81.5. ±. 8.3. years old. The mean APACHE II score was 21.9. ±. 7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1% increase in RDW, p = 0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95% confidence interval [CI]: 0.52-0.74, p = 0.025). In subgroup analysis, for qSOFA <. 2, nonsurvivors had higher RDW levels than survivors (17.0. ±. 3.3 vs. 15.3. ±. 1.4%, p = 0.044). Conclusions: In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <. 2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.

AB - Introduction: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. Methods: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥. 65. years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. Results: A total of 117 patients was included with mean age 81.5. ±. 8.3. years old. The mean APACHE II score was 21.9. ±. 7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1% increase in RDW, p = 0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95% confidence interval [CI]: 0.52-0.74, p = 0.025). In subgroup analysis, for qSOFA <. 2, nonsurvivors had higher RDW levels than survivors (17.0. ±. 3.3 vs. 15.3. ±. 1.4%, p = 0.044). Conclusions: In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <. 2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.

KW - Aged

KW - Red blood cell distribution width

KW - Sepsis

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U2 - 10.1016/j.ajem.2017.10.056

DO - 10.1016/j.ajem.2017.10.056

M3 - Article

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

ER -