Red cell distribution width and mortality in pediatric sepsis

International journal of critical illness and injury science

Sepsis is a pro-inflammatory state caused by systemic infection. As sepsis progresses, multiple organ systems become affected with subsequent increase in mortality. Elevated red cell distribution width (RDW) has been seen with changes of other inflammatory markers and thus could potentially serve as a means of assessing sepsis severity. In this study, we examine the association of RDW with APACHE II score and in-hospital mortality. We conducted a retrospective study involving a cohort of patients with sepsis. The study period spanned 2 years with a cohort of 349 patients. Data were collected to determine if RDW is associated with APACHE II scores and in-hospital mortality in this cohort. RDW correlated weakly (r s = 0.27), but significantly (P < 0.0001) with APACHE II scores; coefficient of determination (r (2) = 0.09). The odds ratios for the association of RDW with APACHE II were calculated over the RDW range 12-20% at a dichotomized level of APACHE II, i.e.,…

BMC Immunology, 2020

Background Outcome prediction for patients with sepsis may be conductive to early aggressive interventions. Numerous biomarkers and multiple scoring systems have been utilized in predicting outcomes, however, these tools were either expensive or inconvenient. We performed a meta-analysis to evaluate the prognostic role of red blood cell distribution width (RDW) in patients with sepsis. Methods The online databases of Embase, Web of science, Pubmed, Corchrane library, Chinese Wanfang database, CNKI database were systematically searched from the inception dates to June, 24th, 2020, using the keywords red cell distribution width and sepsis. The odds ratio (OR) or Hazards ratio (HR) with corresponding 95% confidence intervals (95%CI) were pooled to evaluate the association between baseline RDW and sepsis. A random-effects model was used to pool the data, and statistical heterogeneity between studies was evaluated using the I2 statistic. Sensitivity and subgroup analyses were performed t...

Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics, 2018

To study the clinical value of red blood cell distribution width (RDW) in the early prediction of acute kidney injury (AKI) in children with sepsis. A total of 126 children with sepsis were divided into an AKI group (n=66) and a non-AKI group (n=60) according to the presence or absence of AKI. These patients were also classified into high-RDW and low-RDW groups according to the mean RDW. The groups were compared in terms of age, male-to-female ratio, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, serum blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), serum C-reactive protein (CRP), and routine blood test results. Independent factors associated with RDW were analyzed by multiple linear regression. Age, male-to-female ratio, BMI, CRP, SOFA score, and APACHE II score did not differ significantly between the AKI and non-AKI groups (P>0.05), but the AKI group had significantly hig...

2020

Introduction: Neonatal sepsis is characterized by presence of bacteremia and clinical manifestations caused by microorganisms and their toxic products, when neonatal sepsis identified early and accurately, the degree of severity can be easily determined which help proper management. Therefore, recognizing a single marker or set of markers for diagnosis of such problem may help decrease the global impact of sepsis. Aim of the Work: Evaluation the role of RDW as a marker for diagnosis of neonatal sepsis and a marker for predicting the clinical outcome of the neonatal sepsis. Patients and methods: The study was a prospective study of 100 neonates (75 cases & 25 controls) who were admitted into the neonatal intensive care unit of Al-Hussein University Hospital during the period from June 2018 to April 2019. A Written consentwas obtained from the parents of patients. Results: mean RDW was significantly higher in cases compared to controls (16.55 ± 2.56 & 14.96 ± 1.63 respectively) (P &lt...

Central European Journal of Clinical Research

Red blood cell distribution width (RDW) is a hematological parameter usually measured with every complete blood count. Its place in daily practice is mainly in the differential diagnosis of anemia, but nowadays, researchers are focused on different approaches for the erythrocyte’s changes in function and morphology. Sepsis and its most advanced form, septic shock, induces profound disturbances into organ system’s function and morphology. The red blood cells physiology and structure are directly and indirectly altered by these im balances produced in sepsis. RDW was studied in many diseases, like acute heart failure, acute stroke, inflammatory bowel diseases, chronic lung diseases and cancer, but also in sepsis. Its changes are seen to be mainly associated with prognosis. Higher values of RDW are correlated with mortality and severity of illnes in septic and all-cause critically ill patients. RDW was studied also as an independent variable in different predictive scores and some stud...

International Journal of Contemporary Pediatrics, 2021

Background: We evaluated the usefulness of RDW (red cell distribution width) as a diagnostic tool in newborn sepsis. Several biomarkers for sepsis have been studied including CRP (C-reactive protein), procalcitonin, interleukins, total WBC count (TC) absolute neutrophil count (ANC), ratio of immature neutrophils to total neutrophils (I/T ratio). An ideal biomarker for sepsis is still elusive. Hence we evaluated RDW as a sepsis marker as it was cheap and available. The objective of the study was to evaluate the role of RDW as a prognostic marker in newborn sepsis compared to healthy newborns.Methods: The study sample comprised of two groups (cases and control group) each with 40 neonates. Group 1 (cases group) comprised 40 newborns with suspected/probable sepsis based on clinical or laboratory parameters. In group 1 (suspected/probable sepsis) RDW was done at the time of suspicion of sepsis along with other relevant investigations. According to the clinical course these parameters we...

Fayoum University Medical Journal, 2019

Background: Neonatal sepsis remains a challenge for neonatal care providers. Aim: This work was aiming to measure red cell distribution width percent (RDW %) as a marker for neonatal sepsis and to correlate it with other indicators and with a simple clinical scoring system for neonatal sepsis (Griffin score). Methods: This case control study was carried out at neonatal intensive care unit at Fayoum University Hospital and Abshawai central hospital. Ethical Research Committee Approval and written consents were obtained from parents of the neonates30 neonatal sepsis cases and 30 normal controls. Neonates were subjected to: History taking, clinical examination for manifestations of sepsis. Complete blood count, differential leucocytic count, C-reactive protein, Blood culture, RBS, and determination of RDW % were done to all neonates. Results: Our study showed that I/T ratio and RBS was significantly higher in cases than controls (p<0.001), but WBCs show no statistically significant difference among cases and controls. Moreover, blood culture was positive in 63.3% of cases only. Also, CRP was high in 76.7% of cases and 30% of controls (P=0.01) , and that the mean RDW % was higher among cases than controls (16.4 ± 3.8 and 13.7± 1.6 respectively) (P = 0.001), with further increase in preterm neonates. Also, there was a significant positive correlation between RDW level Griffin score (p=0.001). However, there was insignificant difference between RDW and WBCs or I/T ratio but high RDW level associated with raised RBS level of study group. Conclusion: RDW can serve as a marker and prognostic indicator in neonatal sepsis especially when used together with Griffin score.

Journal of natural science, biology, and medicine

Red cell distribution width (RDW) is a measure of the variation in the red blood cell volume that is usually recorded as a part of the standard complete blood cell count. Recent studies have demonstrated the prognostic value of RDW in many different clinical settings. The objective of this research study is to investigate the independent association of RDW with 30-day mortality in Intensive Care Unit (ICU) patients. One hundred and fifty-six patients admitted to the ICU of our hospital between July 2009 and June 2011 were included in our study. Out of 156 patients, 124 survived the hospital stay. The data on patient&#39;s demographics, interventions done in ICU, and their comorbidities were collected. Baseline variables and the RDW value were compared between survivors and nonsurvivors. The cutoff point for RDW used for the comparison was 15.75. Both univariable and multivariable analyses were done. P &lt; 0.05 was considered statistically significant. In the univariable analysis of...

Prague medical report, 2023

Red distribution width (RDW) has recently been acclaimed as prognostic marker for mortality in critically-ill patients. However, this claim is still unclear and reports are still inadequate for the association between RDW and mortality in critically-ill paediatric patients. This research assessed the correlation between RDW within 24 hours of PICU (paediatric intensive care unit) admission and PELOD-2 score. A cross-sectional study was carried out involving 59 pediatric patients admitted to the PICU Haji Adam Malik Hospital, Medan, Indonesia, from May to July 2019. The association between RDW and PELOD-2 score was assessed by using Spearman correlation test. The RDW level of paediatric patients in the PICU on the first 24 hours was elevated (median 14.7%, range 11.4-31.2%). The median of PELOD-2 score assessment was 8 (range 2-21). There was no significant correlation between RDW and PELOD-2 in this research (r=0.187, p=0.156).

2021

Objective : To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods : In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results : In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of ...