Wang Benji, Gong Yuqiang, Ying Binyu, Cheng Bihuan
Department of Anesthesiology, Critical Care and Pain Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
Biomed Res Int. 2019 Mar 21;2019:1942078. doi: 10.1155/2019/1942078. eCollection 2019.
Currently, evidence regarding the predictive significance of red blood cell distribution width (RDW) among patients with acute respiratory distress syndrome (ARDS) remains scarce. The aim of this study was to determine the prognostic value of RDW for critically ill patients with ARDS.
We studied all patients with ARDS from the Multiparameter Intelligent Monitoring in Intensive Care Database III (MIMIC-III) for whom RDW was available. The clinical outcomes were 30-day and 90-day mortality. Analyses included logistic multivariate regression model, Receiver Operating Characteristic (ROC) analysis, and subgroup analysis.
A total of 404 eligible ARDS patients were included. After adjustment for several clinical characteristics related to 30-day mortality, the adjusted OR (95% CIs) for RDW levels ≥14.5% was 1.91 (1.08, 3.39). A similar trend was observed for 90-day mortality. The RDW levels ≥14.5% were also an independent predictor of 90-day mortality (OR, 2.56; 95% CI, 1.50 to 4.37; = 0.0006) compared with the low RDW levels (<14.5%). In subgroup analyses, RDW showed no significant interactions with other relevant risk factors for 30-day mortality.
RDW appeared to be a novel, independent predictor of mortality in critically ill patients with ARDS.
目前，关于红细胞分布宽度（RDW）在急性呼吸窘迫综合征（ARDS）患者中的预测意义的证据仍然很少。本研究的目的是确定RDW对ARDS重症患者的预后价值。
我们研究了多参数智能重症监护数据库III（MIMIC-III）中所有可获得RDW的ARDS患者。临床结局为30天和90天死亡率。分析包括逻辑多元回归模型、受试者工作特征（ROC）分析和亚组分析。
共纳入404例符合条件的ARDS患者。在调整了与30天死亡率相关的几个临床特征后，RDW水平≥14.5%的调整后OR（95%CI）为1.91（1.08，3.39）。90天死亡率观察到类似趋势。与低RDW水平（<14.5%）相比，RDW水平≥14.5%也是90天死亡率的独立预测因素（OR，2.56；95%CI，1.50至4.37；P = 0.0006）。在亚组分析中，RDW与30天死亡率的其他相关危险因素无显著相互作用。
RDW似乎是ARDS重症患者死亡率的一个新的独立预测因素。
Zotero 插件