Zhang Shaoqiu, Zhang Qun, Wang Jian, Pan Yifan, Zhang Zhiyi, Geng Yu, Jia Bei, Tian Bing, Xiong Yali, Yan Xiaomin, Li Jie, Wang Huali, Huang Rui, Wu Chao
Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China.
Department of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu, People's Republic of China.
J Inflamm Res. 2024 Jul 22;17:4895-4904. doi: 10.2147/JIR.S468388. eCollection 2024.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality rate. This study aimed to investigate the association of red blood cell distribution width (RDW) and mortality risk in hospitalized SFTS patients.
Clinical data of SFTS patients was retrospectively collected from three hospitals between October 2010 and August 2022. Cox proportional hazards model was used to identity the risk factors for fatal outcome. The predictive value of RDW for fatal outcome was evaluated by the receiver operating characteristic (ROC) analysis and Kaplan-Meier methods.
Of 292 patients, the median age was 61.5 years. Non-survivors showed higher RDW value than survivors (13.6% vs.13.0%, P < 0.001). The mortality rate was 44.8% in patients with elevated RDW compared to 18.4% of patients with normal RDW, with a relative risk (RR) of 2.439. Elevated RDW was an independent risk factor of mortality (hazards ratio: 1.167, P = 0.019). Patients with elevated RDW had a higher cumulative mortality than patients with normal RDW. The area under the ROC curve (AUC) of RDW for the prediction of mortality was 0.690 (P < 0.001).
Elevated RDW was associated with higher mortality risk for patients hospitalized for SFTS. RDW may be helpful for risk stratification in SFTS patients.
发热伴血小板减少综合征（SFTS）是一种新出现的具有高死亡率的流行性传染病。本研究旨在探讨住院SFTS患者红细胞分布宽度（RDW）与死亡风险之间的关联。
回顾性收集2010年10月至2022年8月期间三家医院SFTS患者的临床资料。采用Cox比例风险模型确定死亡结局的危险因素。通过受试者工作特征（ROC）分析和Kaplan-Meier方法评估RDW对死亡结局的预测价值。
292例患者的中位年龄为61.5岁。非幸存者的RDW值高于幸存者（13.6%对13.0%，P<0.001）。RDW升高患者的死亡率为44.8%，而RDW正常患者的死亡率为18.4%，相对风险（RR）为2.439。RDW升高是死亡的独立危险因素（风险比：1.167，P=0.019）。RDW升高的患者累积死亡率高于RDW正常的患者。RDW预测死亡率的ROC曲线下面积（AUC）为0.690（P<0.001）。
RDW升高与SFTS住院患者较高的死亡风险相关。RDW可能有助于SFTS患者的风险分层。
