From the Department of Pediatrics, Faculty of Medicine.
Berkit El-Sabaa General Hospital, Menofia Governorate, Egypt.
Pediatr Emerg Care. 2020 Aug;36(8):378-383. doi: 10.1097/PEC.0000000000001319.
The objective of this study was to evaluate a new nontraditional value of the red cell distribution width (RDW) in predicting the clinical outcome of neonatal sepsis.
In this retrospective study, data were collected from the medical files of 500 full-term neonates with a diagnosis of early onset or late onset sepsis. Baseline RDW and other traditional biomarkers, including C-reactive protein (CRP), total leucocytic count, and platelet count were analyzed in light of the clinical data. The primary outcome was 30-day mortality.
Red cell distribution width was significantly higher in nonsurvivors compared with survivors (P < 0.0001). Red cell distribution width was significantly elevated in infants with septic shock compared with those having severe sepsis and those with sepsis (P < 0.0001). A strong positive correlation was found between RDW and CRP (r = 0.8; P <0.0001). Red cell distribution width had an area under the receiver operating characteristic curve of 0.75 for prediction of mortality, which was almost equal to that of CRP and platelet count. Furthermore, logistic regression analysis showed a positive association of RDW with mortality (odds ratio, 1.31; 95% confidence interval, 1.241-1.399).
Red cell distribution width is a useful prognostic marker in neonatal sepsis. Larger prospective studies are required to confirm the value of this routinely available marker in this category of patients.
本研究旨在评估红细胞分布宽度（RDW）的一个新的非传统值在预测新生儿败血症临床结局中的作用。
在这项回顾性研究中，我们从 500 例足月新生儿的病历中收集了数据，这些新生儿被诊断为早发性或晚发性败血症。根据临床数据分析了基线 RDW 和其他传统生物标志物，包括 C 反应蛋白（CRP）、总白细胞计数和血小板计数。主要结局是 30 天死亡率。
与幸存者相比，非幸存者的红细胞分布宽度明显更高（P < 0.0001）。与严重败血症和败血症患儿相比，感染性休克患儿的红细胞分布宽度明显升高（P < 0.0001）。RDW 与 CRP 之间存在强烈的正相关关系（r = 0.8；P < 0.0001）。RDW 预测死亡率的受试者工作特征曲线下面积为 0.75，与 CRP 和血小板计数几乎相等。此外，逻辑回归分析显示 RDW 与死亡率呈正相关（优势比，1.31；95%置信区间，1.241-1.399）。
红细胞分布宽度是新生儿败血症的一种有用的预后标志物。需要更大的前瞻性研究来证实这一常规标志物在这类患者中的价值。
