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VOLUME 21 , ISSUE 9 ( 2017 ) > List of Articles

RESEARCH ARTICLE

Elevated red cell distribution width as a prognostic marker in severe sepsis: A prospective observational study

Subhash Varma, Neelam Varma, Aditya Jandial, Susheel Kumar

Keywords : 30-day mortality, Acute Physiology and Chronic Health Evaluation II score, red cell distribution width, severe sepsis

Citation Information : Varma S, Varma N, Jandial A, Kumar S. Elevated red cell distribution width as a prognostic marker in severe sepsis: A prospective observational study. Indian J Crit Care Med 2017; 21 (9):552-562.

DOI: 10.4103/ijccm.IJCCM_208_17

License: CC BY-ND 3.0

Published Online: 01-09-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Sepsis is a dysregulated host response to infection resulting in potentially life-threatening organ dysfunction. Elevation in red cell distribution width (RDW), a simple routinely done investigation, could be a prognostic marker in these patients. Methods: Between January 2014 and June 2015, 200 patients with severe sepsis at admission were prospectively evaluated for association between RDW at admission and 30-day mortality. Besides the groups of raised and normal RDW, study population was further analyzed after categorizing into three RDW groups as follows: ≤14.5%, 14.6–17.3%, and >17.3% as well. To find out factors associated independently with 30-day mortality, we applied multivariate logistic regression analysis. Results: Among 200 patients, 115 (57.5%) were males. Mean age of the study subjects was 51.32 ± 16.98 years. Mean RDW at admission was 17.40 ± 3.21%, ranging from 12.6% to 33.3%. Mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score of study population at admission was 22.49 ± 5.72. One hundred and fourteen (57%) patients had 30-day mortality. Even though RDW showed a hierarchical association with 30-day mortality among three RDW groups, it was not found to be an independent predictor of 30-day mortality. APACHE II score, serum albumin, partial pressure of arterial oxygen/fraction of inspired oxygen ratio, and serum fibrinogen level at admission were observed to be independent predictors of 30-day mortality. Conclusions: In severe sepsis patients, RDW though showed a graded relationship with 30-day mortality was not found to be an independent predictor of 30-day mortality.


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