Red blood cell distribution width as prognostic factor in sepsis: A new use for a classical parameter

Moreno-Torres, Víctor; Royuela, Ana; Múñez-Rubio, Elena; Gutiérrez-Rojas, Ángela; Mills-Sánchez, Patricia; Ortega, A.; Tejado-Bravo, Sandra; García-Sanz, Javier; Muñoz-Serrano, Alejandro; Calderón-Parra, Jorge; Ramos‐Martínez, Antonio

doi:10.1016/j.jcrc.2022.154069

Cited by 23 publications

(26 citation statements)

References 43 publications

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“…Hampole et al demonstrated that the highest of the three tertiles of RDW was associated with the mortality of pulmonary patients in a multivariate model (HR: 2.4, 95% CI: 1.02, 5.84) with a mean follow‐up duration of 2.1 years 48 . In a recently published article, the authors found that RDW was independently associated with mortality and that 24‐h RDW and admission RDW, when added to the severity scores, could improve the discrimination ability of SOFA, Logistic Organ Dysfunction System, Acute Physiology and Chronic Health Evaluation‐II, and SAPS‐II 49 . However, the underlying mechanism linking RDW with poor prognosis remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the predictive value of elevated RDW for prognosis has been investigated in various studies and groups of patients, e.g., cardiovascular disorders, 46 pulmonary hypertension, 48 sepsis, 24 , 49 and COVID‐19. 50 For heart failure patients, RDW was predictive of mortality 46 (hazard ratio (HR): 1.18; 95% CI: 1.12, 1.24).…”

Section: Discussionmentioning

confidence: 99%

“…48 In a recently published article, the authors found that RDW was independently associated with mortality and that 24‐h RDW and admission RDW, when added to the severity scores, could improve the discrimination ability of SOFA, Logistic Organ Dysfunction System, Acute Physiology and Chronic Health Evaluation‐II, and SAPS‐II. 49 However, the underlying mechanism linking RDW with poor prognosis remains unclear. Researchers have revealed that the association of RDW and RPR with oxidative stress and inflammatory cytokines such as tumor necrosis factor (TNF)‐alpha, interleukin (IL)‐1, and IL‐6 could contribute to its predictive potential.…”

Section: Discussionmentioning

confidence: 99%

“…42,43,46 Therefore, for anemic fracture patients, the value of RDW in the differential diagnosis of anemia may outweigh the prognostic value of mortality. 43,47 On the other hand, the predictive value of elevated RDW for prognosis has been investigated in various studies and groups of patients, e.g., cardiovascular disorders, 46 pulmonary hypertension, 48 sepsis, 24,49 and COVID-19. 50 For heart failure patients, RDW was predictive of mortality 46 (hazard ratio (HR): 1.18; 95% CI: 1.12, 1.24).…”

Section: New Insights Of Studymentioning

confidence: 99%

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Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units

Sun

Zhou

et al. 2022

Orthopaedic Surgery

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Objectives Red blood cell distribution width (RDW) with prognosis in various infectious diseases. For fractured patients admitted to the intensive care units (ICU), an accurate and fast appraisal is essential. To investigate the association between RDW and prognosis in fractured patients admitted to the ICU utilizing the MIMIC‐III database. Methods A retrospective cohort from the MIMIC III database from 2001 and 2012 was constructed. RDW and other information were collected with in‐hospital mortality as the primary outcome and 90‐day mortality and hospital and intensive care unit (ICU) length of stay (LOS) as secondary outcomes. Univariate and multivariate logistic regression models with propensity score inverse probability of treatment weighting (IPTW) were used to investigate the prognostic value of RDW. A nomogram was built with significant prognostic factors to predict in‐hospital mortality, and the performance of the nomogram was evaluated and compared with other severity assessment scores. Subgroup analysis was also conducted. Results A total of 2721 fracture patients admitted to the ICU were identified. After IPTW, the group with higher RDW was significantly associated with elevated in‐hospital mortality (odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.19–2.37), 90‐day mortality (OR: 1.39, 95% CI: 1.04–1.86), prolonged hospital LOS (OR: 1.25, 95% CI: 1.03–1.50), and ICU LOS significantly (OR: 1.26, 95% CI: 1.05–1.53) in the multivariate logistics model. The nomogram showed optimal discriminative ability and predictive accuracy with an area under the receiver operating characteristic curve of 0.77. Conclusion RDW independently predicted in‐hospital mortality, 90‐day mortality, and hospital and ICU LOS in fractured patients admitted to ICU. The nomogram including RDW could also be a promising tool with potential clinical benefits.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: New Insights Of Studymentioning

confidence: 99%

See 2 more Smart Citations

Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units

Sun

Zhou

et al. 2022

Orthopaedic Surgery

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“…Hence, RDW has demonstrated promising applications in intensive care and has been used to assess the prognosis of patients with sepsis, heart failure, and acute respiratory distress syndrome (ARDS) [17][18][19]. When combined with other standard ICU scores, including SOFA, logistic organ dysfunction system, Acute Physiology and Chronic Health Evaluation II, and SAPS II, Moreno-Torres et al discovered that RDW was an independent predictive marker of mortality and enhanced the prediction of death [20]. According to Xiao et al, increased RDW is a signi cant risk factor for developing ARDS after severe burns and plays a signi cant role in predicting its development [21].…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Distribution Width is Associated with Short-term Mortality in Critically Ill Patients with Type 2 Diabetes Mellitus

Chen

Wang

et al. 2022

Preprint

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Background: Red blood cell distribution width (RDW) is associated with increased mortality in many diseases. However, the relationship between RDW fluctuations and the prognosis of critically ill patients with type 2 diabetes mellitus (T2DM) has not been reported. This study investigated the association between baseline RDW levels and dynamic changes and short-term mortality in critically ill patients with T2DM. Methods: All critically ill patients meeting the diagnostic criteria for T2DM in the Medical Information Mart for Intensive Care IV database were retrospectively analyzed. Logistic and Cox regression, Kaplan-Meier survival, and subgroup analyses were used to determine the association between baseline RDW and short-term mortality in critically ill patients with T2DM. Generalized additive mixed models were then used to compare trends in RDW over time between survivors and non-survivors. Results: This study enrolled 6,299 patients with a 28-day mortality rate of 18.4%. Kaplan-Meier analysis showed higher 28-day and 60-day mortality (P<0.001) in the high baseline RDW group. High baseline RDW was revealed by multivariate logistic and Cox regression models as an independent risk factor for in-hospital, 28-day, and 60-day death in critically ill patients with T2DM. An association between elevated baseline RDW and 28-day mortality was observed in all subgroup analyses. The generalized summation mixed-effects model results showed a significant difference in RDW between the surviving and non-surviving groups within 48 h of admission to the intensive care unit (ICU). Moreover, this difference increased with time (β=0.034, P=0.003). Conclusions: Elevated baseline RDW at ICU admission was associated with high short-term mortality in critically ill patients with T2DM, an association that remained significant within 48 h of patient admission to the ICU. Moreover, dynamic monitoring of RDW may help predict short-term mortality in critically ill patients with T2DM. However, this finding requires further validation in prospective studies.

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Promising applications of red cell distribution width in diagnosis and prognosis of diseases with or without disordered iron metabolism

Yang

Wang

Gao

et al. 2023

Cell Biology International

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Many indicators, including red cell distribution width (RDW) and iron metabolism, are sensitive to a variety of risk factors, and are associated with the pathological alterations and disease onset. RDW reflects the degree of heterogeneous volumes of peripheral red blood cells (RBCs). It has been well‐known that increased RDW indicates iron deficiency anemia, hemolytic anemia, ineffective erythropoiesis, and shorten lifespan of RBCs. Increased RDW is also prevalent in various non‐anemic pathological conditions and diseases. We here review the factors affecting RDW, particularly disordered iron metabolism, chronic inflammation, and oxidative stress, and recapitulate the interplays among these factors. Furthermore, we review the application of increased RDW together with disordered iron homeostasis and the deregulations of hepcidin expression and ferritin levels in the diagnoses and prognosis of anemic and nonanemic diseases. RDW is inexpensive and readily available and may be valuable in adding to the diagnosis and monitoring of many pathological conditions. RDW combined with other indicators, for example, hepcidin and ferritin levels, should be utilized more frequently in clinical practice.

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Red blood cell distribution width as prognostic factor in sepsis: A new use for a classical parameter

Cited by 23 publications

References 43 publications

Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units

Elevated Red Blood Cell Distribution Width Is Associated with Poor Prognosis in Fractured Patients Admitted to Intensive Care Units

Red Blood Cell Distribution Width is Associated with Short-term Mortality in Critically Ill Patients with Type 2 Diabetes Mellitus

Promising applications of red cell distribution width in diagnosis and prognosis of diseases with or without disordered iron metabolism

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