Research Article
Volume 4 Issue 5 - 2020
The Use of Red Blood Cell Distribution Width (RDW) as Mortality Predictor in the Intensive Therapy Unit (ITU) at Hospital Ángeles Del Pedregal
Humberto Ochoa Salmorán1*, Ivonne Martínez Martínez2, Silvia Del Carmen Carrillo Ramírez3 and Juan Gerardo Esponda Prado4
1ITU Medical Resident at Hospital Ángeles del Pedregal, Universidad La Salle Medical School, Mexico City, Mexico
2Intensive Medicine Resident at Hospital Ángeles del Pedregal, Universidad La Salle Medical School, Mexico City, Mexico
3ITU Attending Physician at Hospital Ángeles Pedregal, Mexico City, Mexico
4ITU Chief Physician at Hospital Ángeles Pedregal, Mexico City, Mexico
*Corresponding Author: Humberto Ochoa Salmorán, ITU Medical Resident at Hospital Ángeles del Pedregal, Universidad La Salle Medical School, Mexico City, Mexico.
Received: February 22, 2020; Published: April 29, 2020




Abstract

Introduction: Red Blood Cell Distribution (RDW) consists in an index used to determine heterogeneity for red blood cells, which measures anemia or malnutrition disorders. However, its statistical elevation was associated with other inflammation biomarkers. Values above 15% are associated with increased mortality rate in critically ill patients. 

Objective: To determine the RDW increase and mortality ratio, in this environment, for patients in the Intensive Therapy Unit. 

Methodology: Control group consisted of hospitalized patients between March 2018 and August 2018, and the following data was included in the statistical analysis: SOFA, SAPS 3, hemoglobin, hematocrit, leucocytes, platelets, RDW, creatinine, albumin, as well as demographic data. The values assessed by the laboratory team in this unit were considered to be within normal levels. 

Results: Regarding the Chi-squared distribution statistical test, a p value of 0.048 was obtained when linking the number of deaths in the ITU to the RDW values, which proves the relationship between these variables. 

Conclusion: The RDW increase is highly associated with a higher mortality rate and is useful for risk stratification in critically ill patients.

Keywords: Red Cell Distribution; Intensive Therapy Unit; Mortality Rate

References

  1. Ju XF., et al. “Dynamic change of red cell distribution width levels in prediction of hospital mortality in Chinese elderly patients with septic shock”. Chinese Medical Journal 130 (2017): 1189-1195.
  2. Zhang Z., et al. “Red cell distribution width is associated with hospital mortality in unselected critically ill patients”. Journal of Thoracic Disease 5.6 (2013): 730-736.
  3. Meynaar IA., et al. “Red cell distribution width as predictor for mortality in critically ill patients”. Netherlands Journal of Medicine 71.9 (2013): 488-493.
  4. Özdoğan HK., et al. “The predictive value of red cell distribution width levels on mortality in intensive care patients with community-acquired intra-abdominal sepsis”. Ulus Travma Acil Cerrahi Derg 21.5 (2015): 352-357.
  5. Otero TM., et al. “Elevated red cell distribution width at initiation of critical care is associated with mortality in surgical intensive care unit patients”. Journal of Critical Care 34 (2016): 7-11.
  6. Luo R., et al. “Prognostic value of red blood cell distribution width in non-cardiovascular critically or acutely patients: a systematic review”. PLoS One 11.12 (2016): e0167000.
  7. Safdar SA., et al. “The role of red cell distribution width as a predictor of mortality for critically ill patients in an inner-city hospital”. Journal of Natural Science, Biology and Medicine 8.2 (2017): 154-158.
  8. Braun E., et al. “Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia?” BMC Infectious Diseases 14 (2014): 129.
  9. Kim SH., et al. “The association of red cell distribution width and in-hospital mortality in older adults admitted to the emergency department”. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 24 (2016): 81.
  10. Kim S., et al. “Red cell distribution width and early mortality in elderly patients with severe sepsis and septic shock”. Clinical and Experimental Emergency Medicine 2.3 (2015): 155-161.
  11. Vincent JL and Moreno R. “Clinical review: scoring systems in the critically ill”. Critical Care 14.2 (2010): 207.
  12. Afessa B., et al. “Severity of illness and organ failure assessment in adult intensive care units”. Critical Care Clinics 23.3 (2007): 639-658.
  13. Bazick HS., et al. “Red cell distribution width and all-cause mortality in critically ill patients”. Critical Care Medicine 39.8 (2011): 1913-1921.
  14. Hunziker S., et al. “Red cell distribution width improves the simplified acute physiology score for risk prediction in unselected critically ill patients”. Critical Care 16.3 (2012): 89.
  15. Leekha S and Standiford HC. “Empiric antimicrobial therapy for Gram-negative sepsis: back to the future”. Critical Care Medicine 39.8 (2011): 1995-1996. 
  16. Balta S., et al. “Red blood cell distribution width is predictive of mortality in trauma patients”. The Journal of Trauma and Acute Care Surgery 75.2 (2013): 345-346.
  17. Dabbah S., et al. “Relation between red cell distribution width and clinical outcomes after acute myocardial infarction”. The American Journal of Cardiology 105.3 (2010): 312-317. 
  18. Van Kimmenade RR., et al. “Red blood cell distribution width and 1-year mortality in acute heart failure”. European Journal of Heart Failure 12.2 (2010): 129-136.
  19. Aung N., et al. “Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure”. International Journal of Cardiology 168.3 (2013): 1997-2002. 
  20. Felker GM., et al. “Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank”. Journal of the American College of Cardiology 50.1 (2007): 40-47. 
  21. Patel KV., et al. “Red blood cell distribution width and the risk of death in middle-aged and older adults”. Archives of Internal Medicine 169.5 (2009): 515-523. 
  22. Chiari MM., et al. “Influence of acute inflammation on iron and nutritional status indexes in older inpatients”. Journal of the American Geriatrics Society 43.7 (1995): 767-771. 
  23. Deswal A., et al. “Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST)”. Circulation 103.16 (2001): 2055-2059.
  24. Oh HJ., et al. “Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patients treated with continuous renal replacement therapy”. Nephrology Dialysis Transplantation 27.2 (2012): 589-594.
  25. Anderson JL., et al. “Usefulness of a complete blood count-derived risk score to predict incident mortality in patients with suspected cardiovascular disease”. American Journal of Cardiology 99.2 (2007): 169-174.
  26. Tonelli M., et al. “Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease”. Circulation 117.2 (2008): 163-168.
  27. Uyarel H., et al. “Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction”. Coronary Artery Disease 22.3 (2011): 138-144.
Citation: Humberto Ochoa Salmorán., et al. “The Use of Red Blood Cell Distribution Width (RDW) as Mortality Predictor in the Intensive Therapy Unit (ITU) at Hospital Ángeles Del Pedregal”. EC Emergency Medicine and Critical Care 4.5 (2020): 17-24.

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