Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
J Clin Lab Anal. 2020 Sep;34(9):e23373. doi: 10.1002/jcla.23373. Epub 2020 Aug 25.
Red blood cell distribution width (RDW) has been validated valuable in predicting outcome and acute kidney injury (AKI) in several clinical settings. The aim of this study was to explore whether RDW is associated with outcome and AKI in patients with traumatic brain injury (TBI).
Patients admitted to our hospital for TBI from January 2015 to August 2018 were included in this study. Multivariate logistic regression analysis was performed to identify risk factors of AKI and outcome in patients with TBI. The value of RDW in predicting AKI and outcome was evaluated by receiver operating characteristic (ROC) curve.
Three hundred and eighteen patients were included in this study. The median of RDW was 14.25%. We divided subjects into two groups based on the median and compared difference of variables between two groups. The incidence of AKI and mortality was higher in high RDW (RDW > 14.25) group (31.45% vs 9.43%, P < .001; 69.81% vs 29.56%, P < .001). Spearman's method showed RDW was moderately associated with 90-day Glasgow Outcome Scale (GOS) (P < .001). In multivariate logistic regression analysis, RDW, lymphocyte, chlorine, and serum creatinine were risk factors of AKI. And Glasgow Coma Scale (GCS), glucose, chlorine, AKI, and RDW were risk factors of mortality. The area under the ROC curve (AUC) of RDW for predicting AKI and mortality was 0.724 (0.662-0.786) and 0.754 (0.701-0.807), respectively. Patients with higher RDW were likely to have shorter median survival time (58 vs 70, P < .001).
Red blood cell distribution width is an independent risk factor of AKI and mortality in patients with TBI.
红细胞分布宽度（RDW）已在多个临床环境中被验证可用于预测结局和急性肾损伤（AKI）。本研究旨在探讨 RDW 是否与创伤性脑损伤（TBI）患者的结局和 AKI 相关。
本研究纳入了 2015 年 1 月至 2018 年 8 月我院收治的 TBI 患者。采用多变量逻辑回归分析确定 TBI 患者 AKI 和结局的危险因素。通过受试者工作特征（ROC）曲线评估 RDW 预测 AKI 和结局的价值。
本研究共纳入 318 例患者。RDW 的中位数为 14.25%。我们根据中位数将患者分为两组，并比较两组间变量的差异。RDW 较高（RDW＞14.25）组 AKI 和死亡率的发生率更高（31.45%比 9.43%，P＜.001；69.81%比 29.56%，P＜.001）。Spearman 法显示 RDW 与 90 天格拉斯哥预后评分（GOS）中度相关（P＜.001）。多变量逻辑回归分析显示，RDW、淋巴细胞、氯和血清肌酐是 AKI 的危险因素。格拉斯哥昏迷评分（GCS）、血糖、氯、AKI 和 RDW 是死亡率的危险因素。RDW 预测 AKI 和死亡率的 ROC 曲线下面积（AUC）分别为 0.724（0.662-0.786）和 0.754（0.701-0.807）。RDW 较高的患者中位生存时间更短（58 比 70，P＜.001）。
RDW 是 TBI 患者 AKI 和死亡率的独立危险因素。
