Predictive value of RDW for mortality in patients with sepsis and septic shock

Abstract

Background: Sepsis exists on a continuum of severity ranging from infection and bacteremia to sepsis and septic shock, which can lead to multiple organ dysfunction syndrome (MODS) and death. The global burden of sepsis is difÏcult to ascertain, although a recent scientific publication estimated that in 2017 there were 48.9 million cases and 11 million sepsis-related deaths worldwide, which accounted for almost 20% of all global deaths. Prognostication in severe sepsis may facilitate aggressive management of particular patient groups. Prognostic factors such as age, sex, comorbidities, biomarkers (Creactive protein [CRP], procalcitonin, etc.,), and severity of illness score (Acute Physiology and Chronic Health Evaluation [APACHE], etc.,) have been reported to be associated with the outcome in cases of severe sepsis. RDW could be a useful tool in prognostication of cases with severe sepsis as described in recent studies. Materials and Methods: This is single-centred, retrospective observational study that included 103 patients with infected and sepsis in the Emergency department of First Central hospital which is one of the biggest tertiary hospital between 1 January 2020 and 1 June 2020 and pattients admitted Intensive care unit, which were observed all patients non-survived. Results: Among 103 patients, 54 (52.4%) were male. Mean age of study subjects was 57.9±14.6 years. We divided 3 main groups which were infected, sepsis and septic shock that were singnificantly associated with lymphocytis (p=0.009), neutrophil (p=0.02), creatinine (p=0.000), total bilirubine (p=0.03), albumine (p=0.006), neutrophil lymphocytis ratio (p=0.03), trombocytis (p=0.001), Early warning score (p=0.001), SOFA (p=0.001), RDW (p=0.000). SOFA scores: 2–5, 6–10 and >10 were significantly associated between RDW 14.8±11.6; 16±1.3; 9±1.8; (p=0.000) respectively. Conclusion: The results showed that increasing SOFA score follow to increase RDW. RDW appeared to be associated with infection, sepsis and septic shock so RDW measurements could be used as a prognostic factor in sepsis and septic shock