Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, P.R. China.
J Thorac Dis. 2013 Dec;5(6):730-6. doi: 10.3978/j.issn.2072-1439.2013.11.14.
Red cell distribution width (RDW) is a variability of red cell sizes and has been associated with outcomes in many clinical settings. Its prognostic value in intensive care unit (ICU) has been reported but requires confirmation. The study aimed to investigate the role of RDW in predicting hospital mortality in critically ill patients.
This is a retrospective study conducted in a 24-bed ICU of a tertiary teaching hospital. Data on demographic characteristics and laboratory measurements were collected from medical information database. Baseline variables were compared between survivors and nonsurvivors. The primary endpoint was hospital mortality; and ICU length of stays (LOS) were compared between patients with RDW >14.8% and ≤14.8%. The predictive value of RDW was also measured using receiver operating characteristic (ROC) curves. Two-sided P<0.05 was considered to be statistically significant.
A total of 1,539 patients were enrolled during study period, including 1,084 survivors and 455 nonsurvivors. In univariate analysis, variables such as age, sex, primary diagnosis, C-reactive protein (CRP), RDW and albumin were significantly associated with hospital mortality. RDW remained significantly associated with mortality after adjustment for sex, age, Charlson index albumin and CRP, with an odds ratio of 1.1 (95% CI: 1.03-1.16). Diagnostic performance of RDW in predicting mortality appeared to be suboptimal (AU-ROC: 0.62). Changes in RDW during a short follow up period were not associated with mortality.
RDW measured on ICU entry is associated with hospital mortality. Patients with higher RDW will have longer LOS in ICU. Repeated measurements of RDW provide no additional prognostic value in critically ill patients.
红细胞分布宽度（RDW）是红细胞大小的变异性，与许多临床环境下的结果有关。其在重症监护病房（ICU）中的预后价值已有报道，但仍需要证实。本研究旨在探讨 RDW 在预测危重症患者住院死亡率中的作用。
这是一项在一家三级教学医院的 24 张床位 ICU 中进行的回顾性研究。从医疗信息数据库中收集人口统计学特征和实验室测量数据。比较幸存者和非幸存者之间的基线变量。主要终点是住院死亡率；并比较 RDW＞14.8%和≤14.8%的患者的 ICU 住院时间（LOS）。还使用接收者操作特征（ROC）曲线测量 RDW 的预测价值。双侧 P<0.05 被认为具有统计学意义。
在研究期间共纳入 1539 例患者，包括 1084 例幸存者和 455 例非幸存者。单因素分析显示，年龄、性别、主要诊断、C 反应蛋白（CRP）、RDW 和白蛋白等变量与住院死亡率显著相关。在校正性别、年龄、Charlson 指数、白蛋白和 CRP 后，RDW 与死亡率仍显著相关，优势比为 1.1（95%CI：1.03-1.16）。RDW 预测死亡率的诊断性能似乎不佳（AU-ROC：0.62）。在短时间随访期间，RDW 的变化与死亡率无关。
ICU 入院时测量的 RDW 与住院死亡率相关。RDW 较高的患者在 ICU 的 LOS 较长。对 RDW 的重复测量在危重症患者中没有提供额外的预后价值。
