Association Between Red Cell Distribution Width and Hospital Mortality in Patients with Sepsis

Abstract

Objective Sepsis is the leading cause of death in patients admitted to adult intensive care units (ICUs). We aimed to determine the predictive value of red blood cell distribution width (RDW) in patients with sepsis in a large cohort. Methods This retrospective observational study used data from the eICU Collaborative Research Database. The prognostic value of RDW was investigated using the receiver operating characteristic (ROC) curve, multiple logistic regression model, integrated discriminatory index (IDI), and net reclassification index (NRI). Results In total, 9743 patients were included. The area under the ROC curve of the RDW for predicting hospital mortality was 0.631 (95% confidence interval [CI]: 0.616–0.645). Based on the multiple logistic regression model, an RDW of ≥14.5% was correlated with hospital mortality, regardless of Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scores (odds ratio [OR]: 1.838, 95% CI: 1.598–2.119). Using SOFA and APACHE IV scores as reference, the IDI and continuous NRI of RDW for hospital mortality was about 0.3 and 0.014, respectively. Conclusions The RDW may be useful in predicting hospital mortality in patients with sepsis, offering extra prognostic value beyond SOFA and APACHE IV scores.