Prognostic Value of Red Cell Distribution Width in Critically Ill Patients and Comparison with Intensive Care Unit Scoring Systems
Clinic of Emergency Medicine, Konya Training and Resarch Hospital, Konya, Turkey
Department of Emergency Medicine, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
Eurasian J Emerg Med 2017; 16: 2-7
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Key Words: Acute physiology and chronic health evaluation II score, critical patient, intensive care, lactate, red cell distribution width, sequential organ failure assessment score
Aim: This study aimed to investigate the prognostic value of lactate and red cell distribution width (RDW) parameters of patients admitted to emergency service and critical care unit (CCU).
Materials and Methods: A total of 147 patients hospitalized in the CCU of Necmettin Erbakan University, Meram Faculty of Medicine, Department of Emergency Medicine, were included in the study. Vital signs, laboratory results, lactate, and RDW values of the patients were recorded. Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated. Duration of hospitalization and intensive care unit stay and mortalities were recorded. Chi-square, Fisher's exact chi-square, and Student t tests were used for statistical analyzes, and Mann-Whitney U test was used for comparing nonparametric data that were not compatible with a normal distribution. P<0.05 were accepted as statistically significant. Spearman correlation analysis was used to assess whether a linear correlation existed between the parameters.
Results: A statistically significant correlation was found between the duration of stay in the CCU for <7 days and total duration of hospitalization (p<0.001). Also, statistically significant correlations were observed between mortalities of 28 days and 3 months, APACHE II and SOFA scores, and mean lactate (for 24 h and during hospitalization) and RDW values (p<0.001, p<0.001, p<0.001, and p<0.05, respectively). Moreover, correlations were noted between APACHE II scores, lactate value during the first admission, and SOFA scores (p<0.001). Correlations were also observed between 48-h SOFA scores and RDW and lactate values (p<0.001).
Conclusion: SOFA and APACHE II are the scoring systems used in practice. Efficiencies for mortality assessment of critical patients were confirmed. This study showed that lactate and RDW values, which were compatible with the scoring systems, could be used for assessing prognosis. Wider and more comprehensive studies that can assess scoring systems and lactate and RDW values together for prognostic identification are required to validate the findings.