Department of Surgery and Public Health Sciences , Loyola University Medical Center , Maywood , IL , USA.
759th Forward Surgical Team , BLDG A-6631 Gorham Street , 28310-0001 Fort Bragg , NC , USA.
J Osteopath Med. 2021 Feb 1;121(2):221-228. doi: 10.1515/jom-2020-0089.
Red blood cell distribution width (RDW) has been used to predict mortality during infection and inflammatory diseases. It also been purported to be predictive of mortality following traumatic injury.
To identify the role of RDW in predicting mortality in trauma patients. We also sought to identify the role of RDW in predicting the development of sepsis in trauma patients.
A retrospective observational study was performed of the medical records for all adult trauma patients admitted to Loyola University Medical Center from 2007 to 2014. Patients admitted for fewer than four days were excluded. Admission, peak, and change from admission to peak (Δ) RDW were recorded to determine the relationship with in-hospital mortality. Patient age, development of sepsis during the hospitalization, admission to the intensive care unit (ICU), and discharge disposition were also examined.
A total of 9,845 patients were admitted to the trauma service between 2007 and 2014, and a total of 2,512 (25.5%) patients fit the inclusion criteria and had both admission and peak values available. One-hundred twenty (4.6%) died while in the hospital. RDW values for all patients were (mean [standard deviation, SD]): admission 14.09 (1.88), peak 15.09 (2.34), and Δ RDW 1.00 (1.44). Admission, peak, and Δ RDW were not significant predictors of mortality (all p>0.50; hazard ratio [HR], 1.01-1.03). However, trauma patients who eventually developed sepsis had significantly higher RDW values (admission RDW: 14.27 (2.02) sepsis vs. 13.98 (1.73) no sepsis, p<0.001; peak RDW: 15.95 (2.55) vs. 14.51 (1.97), p<0.001; Δ RDW: 1.68 (1.77) vs. 0.53 (0.91), p<0.001).
Admission, peak, and Δ RDW were not associated with in-hospital mortality in adult trauma patients with a length of stay (LOS) ≥four days. However, the development of sepsis in trauma patients is closely linked to increased RDW values and in-hospital mortality.
红细胞分布宽度（RDW）已被用于预测感染和炎症性疾病期间的死亡率。它也被认为可以预测创伤后的死亡率。
确定 RDW 在预测创伤患者死亡率中的作用。我们还试图确定 RDW 在预测创伤患者发生脓毒症中的作用。
对 2007 年至 2014 年期间入住洛约拉大学医学中心的所有成年创伤患者的病历进行回顾性观察研究。排除住院时间少于 4 天的患者。记录入院时、峰值时和从入院到峰值的变化（Δ）RDW，以确定与住院死亡率的关系。还检查了患者年龄、住院期间发生脓毒症、入住重症监护病房（ICU）和出院情况。
2007 年至 2014 年期间，共有 9845 名患者入住创伤科，共有 2512 名（25.5%）患者符合纳入标准，且均有入院和峰值值。共有 120 人（4.6%）在住院期间死亡。所有患者的 RDW 值为（平均值[标准差，SD]）：入院时 14.09（1.88），峰值时 15.09（2.34），Δ RDW 1.00（1.44）。入院时、峰值时和Δ RDW 均不是死亡率的显著预测因子（均 p>0.50；危险比[HR]，1.01-1.03）。然而，最终发生脓毒症的创伤患者的 RDW 值显著较高（入院时 RDW：14.27（2.02）与无脓毒症患者的 13.98（1.73）相比，p<0.001；峰值 RDW：15.95（2.55）与 14.51（1.97）相比，p<0.001；Δ RDW：1.68（1.77）与 0.53（0.91）相比，p<0.001）。
在住院时间（LOS）≥4 天的成年创伤患者中，入院时、峰值时和Δ RDW 与住院死亡率无关。然而，创伤患者发生脓毒症与 RDW 值升高和住院死亡率密切相关。
