Role of red blood cell distribution width in predicting the prognosis of patients with sepsis

Abstract

Background: Sepsis is a dangerous disease with rapid development and high mortality rate, which is an important cause of death for critically ill patients. Therefore, timely and accurate assessment of patients’ condition is beneficial to improve prognosis and reduce mortality. Objective: This study was designed to investigate the potential correlation between red blood cell distribution width and 28-day prognosis of patients with sepsis. Methods: A prospective observational study enrolling 236 patients with sepsis or septic shock was performed at our hospital. All cases were divided into survival versus non-survival group on 28th day after diagnosis. The two groups were compared for general condition, underlying diseases, quick Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II score, C-reactive protein, procalcitonin, and red blood cell distribution width at admission. Results: The red blood cell distribution width level in non-survivors was higher than that in survivors (16.3 ± 2.8 vs 15.2 ± 1.7, p = 0.013). Cox regression analysis indicated that red blood cell distribution width was an independent predictor for 28-day mortality (hazard ratio: 1.311, 95% confidence interval: 1.119–3.011, p = 0.018). The red blood cell distribution width cutoff value of red blood cell distribution width for 28-day mortality was 16.1%, while patients with lower red blood cell distribution width levels had a better prognosis as demonstrated by Kaplan–Meier survival curves (log-rank = 7.398, p = 0.007). Unlike the septic shock group, in the sepsis group, the red blood cell distribution width level was higher in the non-survival group compared to the survival group (15.82% ± 0.93% vs 15.01% ± 0.89%, p < 0.001). Conclusion: Increased red blood cell distribution width may be an important predictor of disease progression and prognosis in patients with sepsis and septic shock. In the sepsis group, higher red blood cell distribution width levels predict poor prognosis.