A Predictive Model for Acute Respiratory Distress Syndrome Mortality Using Red Cell Distribution Width

Author:

Alkhatib Ala1ORCID,Price Lori Lyn23,Esteitie Rania4,LaCamera Peter5ORCID

Affiliation:

1. Department of Medicine, Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Tulane University Health Science Center, New Orleans, LA, USA

2. Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA

3. The Institute for Clinical Research and Health Policy Study, Tufts Medical Center, Boston, MA, USA

4. Department of Pulmonary and Critical Care, Covenant Healthcare, Saginaw, MI, USA

5. Department of Pulmonary and Critical Care, St. Elizabeth’s Medical Center, Boston, MA, USA

Abstract

Methods. This observational retrospective cohort study includes 318 ARDS patients extracted from an ICU database between the years of 2001 and 2008. Clinical factors including age, gender, comorbidity score, Sequential Organ Failure Assessment (SOFA) score, and PaO2/FiO2 ratio were chosen for the base model to predict ICU mortality. The RDW value at the time of ARDS diagnosis was added to the base model to determine if it improved its predictive ability. Results. 318 subjects were included; 113 (36%) died in the ICU. AUC for the base model without RDW was 0.76, and 0.78 following the addition of RDW [p=0.048]. The NRI was 0.46 (p=0.001), indicating that, in 46% of patients, the predictive probability of the model was improved by the inclusion of RDW. Conclusions. Adding RDW at time of ARDS diagnosis improved discrimination in a model using 4 clinical factors to predict ICU mortality.

Publisher

Hindawi Limited

Subject

Critical Care and Intensive Care Medicine

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