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红细胞分布宽度在有机磷中毒严重程度预测中的预后价值:一项基于医院的前瞻性观察研究

Prognostic value of red blood cell distribution width in organophosphorus poisoning severity prediction: A hospital-based prospective observation.

作者信息

Tripathy Krishna Padarabinda, Nair Aswathy A, Behera Pradip K, Panda Bandita

机构信息

General Medicine Department, Kalinga Institute of Medical Sciences, KIIT DU, Odisha, India.

Research and Development Department, Kalinga Institute of Medical Sciences, KIIT DU, Odisha, India.

出版信息

J Family Med Prim Care. 2025 Mar;14(3):1017-1023. doi: 10.4103/jfmpc.jfmpc_1346_24. Epub 2025 Mar 25.

Abstract

BACKGROUND

The present study aims to access the prognostic value of red blood cell distribution width (RDW) in severity of organophosphate poisoning and compare with Peradeniya organophosphate poisoning (POP) and clinical outcomes.

METHODS

A total of 70 patients were admitted to the hospital due to organophosphate poisoning, and the severity was accessed by POP scale. The prognostic value of RDW was accessed and compared with disease severity prospectively at three-time points (during admission time, 48 hours, and 96 hours), and a follow-up was made for the outcome in terms of duration of hospital stay, the requirement of ventilator support, and mortality.

RESULTS

Based on receiver operating characteristic (ROC) analysis, the cutoff value of RDW was determined to be 16.1 with 88.24% sensitivity and 81.13% specificity and significantly compared with the POP score (a value of < 0.0001). RDW is positively correlated with the POP score. During admission time, the cutoff value of RDW is found to be 16.8 with 66.67% sensitivity and 81.82% specificity and significantly comparable with POP score ( value = 0.0230), whereas in the case of patients with ventilator support, the cutoff value of RDW is >17, with a sensitivity of 90.91% and a specificity of 88.14%, which is highly significant in comparison with POP score ( value= <0.0001).

CONCLUSION

Subsequent ROC analysis indicates that at hospital admission, RDW can be considered as a reliable marker for predicting the duration of hospital stay and the need for ventilator support and can also be used for prognosis as well as risk stratification of patients with organophosphate poisoning.

摘要

背景

本研究旨在评估红细胞分布宽度(RDW)对有机磷中毒严重程度的预后价值,并与佩拉德尼亚有机磷中毒(POP)及临床结局进行比较。

方法

共有70例因有机磷中毒入院的患者,其严重程度通过POP量表进行评估。前瞻性地在三个时间点(入院时、48小时和96小时)评估RDW的预后价值,并与疾病严重程度进行比较,同时对住院时间、呼吸机支持需求和死亡率等结局进行随访。

结果

基于受试者工作特征(ROC)分析,确定RDW的截断值为16.1,灵敏度为88.24%,特异度为81.13%,与POP评分相比差异有统计学意义(P值<0.0001)。RDW与POP评分呈正相关。入院时,RDW的截断值为16.8,灵敏度为66.67%,特异度为81.82%,与POP评分相比差异有统计学意义(P值=0.0230);而在需要呼吸机支持的患者中,RDW的截断值>17,灵敏度为90.91%,特异度为88.14%,与POP评分相比差异极有统计学意义(P值<0.0001)。

结论

后续的ROC分析表明,入院时RDW可被视为预测住院时间和呼吸机支持需求的可靠标志物,也可用于有机磷中毒患者的预后评估及风险分层。

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