Red Cell Distribution Width is Predictive of Mortality in Intensive Care Patients with community-acquired Intra-abdominal Sepsis

Abstract

BACKGROUND: Red cell distribution width (RDW) is a part of the complete blood count (CBC) panel reflecting quantitative mea-sure of variability in the size of circulating red blood cells. It has been known that higher RDW is associated with increased mortality in several diseases. The aim of this study was to investigate the association between RDW and hospital mortality in intensive care unit (ICU) patients with community-acquired intra-abdominal sepsis (C-IAS). METHODS: A retrospective analysis of the patients with C-IAS was performed between January 1, 2010 and March 31, 2013. Patients' demographics, co-morbidities, laboratory measures including RDW on admission to the ICU, and Acute Physiologic and Chronic Health Evaluation II (APACHE II) score were analyzed. RESULTS: A total of one hundred and three patients with C-IAS were included into the study with a mean age of 64±14 years. Overall mortality was 50.5%. RDW day 1 (RDW1) values and APACHE II scores were significantly higher in non-survivors than in sur-vivors. In multivariate analysis, only RDW1 and APACHE II predicted mortality. The area under the receiver operating curves (AUC) of RDW1 and APACHE II were 0.867 (95% CI, 0.791–0.942) and 0.943 (95% CI, 0.902–0.984), respectively. CONCLUSION: This study suggests that increased RDW is associated with mortality in ICU patients with C-IAS.