Topaz Guy, Kitay-Cohen Yona, Peled Lee, Gharra Wesal, Kaminer Keren, Eitan Mayan, Mahamid Lamis, Shilo Lotan
Department of Internal Medicine "C", Meir Hospital, Kfar-Saba and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Internal Medicine "C", Meir Hospital, Kfar-Saba and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Crit Care. 2017 Oct;41:166-169. doi: 10.1016/j.jcrc.2017.05.014. Epub 2017 May 23.
To examine an association between red blood cell distribution width (RDW) and the prognosis of influenza patients.
We conducted a retrospective analysis of patients hospitalized with influenza during 2012-2015 in the internal medicine wards of one medical center. RDW measurements during hospitalization were analyzed. Primary outcome was complicated hospitalization (defined as at least one of: length of stay ≥7days, need for mechanical ventilation, septic shock, transfer to intensive-care, or 30-day mortality). Secondary outcome was 30-day mortality.
153 patients were included, mean age: 62.5±1, 82 (54%) male; 84 (55%) had a high RDW value (>14.5%) during hospitalization. Patients with high and low RDW (≤14.5%) had similar age and comorbidity profiles, but those with high RDW had lower hemoglobin and higher creatinine levels. Patients with high RDW had a higher rate of complicated hospitalization (32.5% vs. 10.3%, p<0.01) and a trend for increased 30-day mortality. In a multivariate regression model, high RDW was a predictor of complicated hospitalization (OR 5.03, 95% CI 1.81-13.93, p<0.01). Each 1-point increase in RDW was associated with a 29% increase in the risk for the primary outcome.
RDW>14.5% was a predictor of severe hospital complications in patients with influenza.
探讨红细胞分布宽度（RDW）与流感患者预后之间的关联。
我们对2012年至2015年期间在某医疗中心内科病房住院的流感患者进行了回顾性分析。分析了住院期间的RDW测量值。主要结局为复杂住院情况（定义为以下至少一项：住院时间≥7天、需要机械通气、感染性休克、转入重症监护病房或30天死亡率）。次要结局为30天死亡率。
纳入153例患者，平均年龄：62.5±1岁，82例（54%）为男性；84例（55%）在住院期间RDW值较高（>14.5%）。RDW值高和低（≤14.5%）的患者年龄和合并症情况相似，但RDW值高的患者血红蛋白水平较低，肌酐水平较高。RDW值高的患者复杂住院率较高（32.5%对10.3%，p<0.01），且30天死亡率有增加趋势。在多变量回归模型中，高RDW是复杂住院情况的预测因素（比值比5.03，95%置信区间1.81 - 13.93，p<0.01）。RDW每增加1个单位，主要结局风险增加29%。
RDW>14.5%是流感患者严重医院并发症的预测因素。
