Red cell distribution width and early mortality in elderly patients with severe sepsis and septic shock

Abstract

OBJECTIVE To investigate the association of red cell distribution width (RDW) with 30-day mortality in elderly patients with severe sepsis and septic shock. METHODS Patients were recruited from a single tertiary emergency department. Patients with age over 65 years were selected. The main outcome was 30-day mortality. Potential confounders as Acute Physiologic and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score along with initial vital signs were collected. Multivariate Cox proportional hazards analysis was performed to identify independent predictors of 30-day mortality. The discriminative ability of RDW for 30-day mortality was evaluated using receiver operating characteristic curve analysis. RESULTS Overall, 458 patients were included. Univariate analysis showed that patients' survival was significantly associated with sites of infection, comorbidities, and severity scores. In the multivariate Cox proportional hazard model, the RDW was an independent predictor of 30-day mortality (hazards ratio, 1.10; 95% confidence interval, 1.04 to 1.17; P<0.001). CONCLUSION In this study, initial RDW values were significantly associated with 30-day mortality in older patients hospitalized with severe sepsis and septic shock.