Prognostic value of dynamic determination of red cell distribution width concentrations for sepsis:aretrospective study

doi:10.3969/j.issn.1002-1949.2015.05.002

Abstract：Objective To investigate the prognostic value of dynamic determination of red cell distribution width ( RDW) in sepsic patients.Methods A total of 161 Patients were selected and recorded in ICU department in Shanghai Changzheng Hospital from January of 2012 to December of 2013.RDW concentrations on Day 1(D1), Day 3(D3), Day 5(D5)and Day 7(D7)were recorded, andΔD3(D3-D1), ΔD5(D5 -D1), ΔD7(D7 -D1) were calculated.They were divided into two groups by different outcome.ΔRDW were compared between two groups.In addition, Logistic regression analysis was performed to determine the risk factors for mortality.ΔRDW, APACHEⅡscore and SOFA score were evaluated using receiver operating characteristic curve ( ROC ) .Results Among the 161 included sepsis patients, 126 cases were survivors and the other 35 cases were non-survivors.Non-survivors had a higher level of ΔRDW than survivors (P<0.01).Higher ΔRDW was associated with higher mortality.ΔD7 was an independent risk factor for mortality(OR=0.58, 95%CI 0.352~0.946, P=0.029).Estimating the receiver operating characteristic area under the curve shows that ΔD7, APACHEⅡ score and SOFA score can evaluate sepsis patients prognosis as the same ( AUC 0.807, 0.802, 0.810;P<0.001) .Sensitivity ofΔD7 was higher than two kinds of scores system.Conclusion Dynamic determination of RDW can evaluatethe prognosis of sepsis patients.It shows a very good prognosis prediction for sepsis within one week after admission.