Sabry, S., Abo Hamila, M., Mohamed, M., Mohammed, A. (2024). Impact of Red Cell and Platelet Distribution Width in High Risk Septic Patients and Their Prognostic Value. test, 4(2), 51-75. doi: 10.21608/jicem.2024.296301.1040
Sherif Medhat Sabry; Mohamed Abdelkader Abo Hamila; Mohamed Abd Elmonaem Mohamed; Ahmed Yassien Mohammed. "Impact of Red Cell and Platelet Distribution Width in High Risk Septic Patients and Their Prognostic Value". test, 4, 2, 2024, 51-75. doi: 10.21608/jicem.2024.296301.1040
Sabry, S., Abo Hamila, M., Mohamed, M., Mohammed, A. (2024). 'Impact of Red Cell and Platelet Distribution Width in High Risk Septic Patients and Their Prognostic Value', test, 4(2), pp. 51-75. doi: 10.21608/jicem.2024.296301.1040
Sabry, S., Abo Hamila, M., Mohamed, M., Mohammed, A. Impact of Red Cell and Platelet Distribution Width in High Risk Septic Patients and Their Prognostic Value. test, 2024; 4(2): 51-75. doi: 10.21608/jicem.2024.296301.1040

Impact of Red Cell and Platelet Distribution Width in High Risk Septic Patients and Their Prognostic Value

The Egyptian Journal of Intensive Care and Emergency Medicine
Volume 4, Issue 2, June 2024, Pages 51-75    PDF (652.95 K)
Document Type: Original papers
DOI: 10.21608/jicem.2024.296301.1040
Authors
Sherif Medhat Sabry1; Mohamed Abdelkader Abo Hamila2; Mohamed Abd Elmonaem Mohamed* 1; Ahmed Yassien Mohammed1
1Critical Care Medicine department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
2Critical care medicine department, Faculty of medicine, Beni- suef University, Beni-suef 62511,Egypt.
Abstract
Background: The red blood distribution width (RDW) and Platelet distribution width (PDW) are useful in predicting morbidity and mortality in sepsis. Objectives: to evaluate the prognostic importance of RDW and PDW, and detect the correlation between RDW, PDW and Sequential Organ Failure Assessment (SOFA) score in predicting mortality, length of stay in ICU and need for mechanical ventilation (MV) in septic patients. Methods: In this observational cohort prospective study, 49 patients admitted to the Critical Care Unit at Beni-Suef University Hospital were defined on the basis of qSOFA greater than 2. Upon admission, all patients underwent a series of sepsis monitoring and assessments. CBC, platelet, PDW, RDW and SOFA score were evaluated. Results: The average number of days that septic patients spent in the ICU was 17.94. There is a statistically significant relationship between SOFA score on admission and after 48 hours with the outcome data of mortality, need for ventilation, PDW and RDW, but not with ICU stay days. RDW revealed a specificity of 31.30% and a sensitivity of 82.40%. PDW, revealed a specificity of 68.8% and a sensitivity of 94.1%. The AUC for SOFA was 0.809; the optimal cutoff value was 4.5, with a specificity of 43.80% and a sensitivity of 88.20%. Conclusion: RDW and PDW were found as significant indicators for need for MV, mortality in sepsis. PDW is the gold standard for predicting mortality in high-risk septic patients; better than RDW.
Keywords
Red cell distribution width; Platelet distribution width; Septic Patients; Sequential organ failure assessment score
References

  1. Uffen, J.W., Oomen, P., De Regt, M., Oosterheert, J.J. and Kaasjager, K., 2019. The prognostic value of red blood cell distribution width in patients with suspected infection in the emergency department. BMC Emergency Medicine, 19(1), pp.1-7.
  2. Zhang, H. B., Chen, J., Lan, Q. F., Ma, X. J., & Zhang, S. Y. (2016). Diagnostic values of red cell distribution width, platelet distribution width and neutrophil-lymphocyte count ratio for sepsis. Experimental and Therapeutic Medicine, 12(4), 2215–2219.
  3. Li, Y., She, Y., Fu, L., Zhou, R., Xiang, W., & Luo, L. (2021). Association Between Red Cell Distribution Width and Hospital Mortality in Patients with Sepsis. Journal of International Medical Research, 49(4).
  4. Zhang L, Qiu C, Yang L, Zhang Z, Zhang Q, Wang B, et al. GPR18 expression on PMNs as biomarker for outcome in patient with sepsis. Life Sci. 2019;217:49–56.
  5. Dubey, A., Kumar, S., Acharya, S., Wanjari, A. K., Bawankule, S., Agrawal, S., & Shukla, A. (2021). Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit. Journal of Laboratory Physicians.
  6. Wang, T. H., & Hsu, Y. C. (2021). Red cell distribution width as a prognostic factor and its comparison with lactate in patients with sepsis. Diagnostics, 11(8).
  7. Lorente, L., Martín, M. M., Abreu-González, P., Solé-Violán, J., Ferreres, J., Labarta, L., Díaz, C., González, O., García, D., Jiménez, A., & Borreguero-León, J. M. (2014). Red blood cell distribution width during the first week is associated with severity and mortality in septic patients. PLoS ONE, 9(8). https://doi.org/10.1371/journal.pone.0105436.
  8. Jarczak D, Kluge S, Nierhaus A. Sepsis—pathophysiology and therapeutic concepts. Front Med. 2021;609.
  9. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–11.
  10. Li Y, She Y, Fu L, Zhou R, Xiang W, Luo L. Association between red cell distribution width and hospital mortality in patients with sepsis. J Int Med Res. 2021;49(4):03000605211004221.
  11. Zhang L, Qiu C, Yang L, Zhang Z, Zhang Q, Wang B, et al. GPR18 expression on PMNs as biomarker for outcome in patient with sepsis. Life Sci. 2019;217:49–56.
  12. Wang TH, Hsu YC. Red cell distribution width as a prognostic factor and its comparison with lactate in patients with sepsis. Diagnostics. 2021;11(8):1474.
  13. Lorente L, Martín MM, Abreu-González P, Solé-Violán J, Ferreres J, Labarta L, et al. Red blood cell distribution width during the first week is associated with severity and mortality in septic patients. PLoS One. 2014;9(8):e105436.
  14. Kim CH, Park JT, Kim EJ, Han JH, Han JS, Choi JY, et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Crit care. 2013;17(6):1–8.
  15. Jiang Y, Jiang FQ, Kong F, An MM, Jin BB, Cao D, et al. Inflammatory anemia-associated parameters are related to 28-day mortality in patients with sepsis admitted to the ICU: a preliminary observational study. Ann Intensive Care. 2019;9:1–11.
  16. Takegawa R, Kabata D, Shimizu K, Hisano S, Ogura H, Shintani A, et al. Serum albumin as a risk factor for death in patients with prolonged sepsis: an observational study. J Crit Care. 2019;51:139–44.
  17. Chen Y, Hu Y, Zhang J, Shen Y, Huang J, Yin J, et al. Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study. BMC Anesthesiol. 2019;19:1–12.
  18. Abu-Humaidan AHA, Ahmad FM, Maysaa’A AB, Hani AB, Abeeleh MA. Characteristics of adult sepsis patients in the intensive care units in a tertiary hospital in Jordan: an observational study. Crit Care Res Pract. 2021;2021.
  19. Brink A, Alsma J, Verdonschot RJCG, Rood PPM, Zietse R, Lingsma HF, et al. Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS One. 2019;14(1):e0211133.
  20. Lie KC, Lau CY, Van Vinh Chau N, West TE, Limmathurotsakul D. Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: a multinational multicenter prospective observational study. J intensive care. 2018;6:1–8.
  21. Li X, Yin Z, Yan W, Wang M, Xue L, Zhou Q, et al. Baseline red blood cell distribution width and perforin, dynamic levels of interleukin 6 and lactate are predictors of mortality in patients with sepsis. J Clin Lab Anal. 2023;37(3):e24838.
  22. Elkholy MM, Osman MA, Abd El Basset AS, El Maraghi SK, Saber HM. Evaluation of intensive care unit acquired weakness in patients with sepsis. Egypt J Intensive Care Emerg Med. 2023;3(1):7–19.
  23. Taha RS, Afandy ME, Elbadawi AH, Abd El Ghafar MS. Platelet indices in critically ill septic patients as a predictor of mortality. Egypt J Anaesth. 2023;39(1):56–62.
  24. Innocenti F, Tozzi C, Donnini C, De Villa E, Conti A, Zanobetti M, et al. SOFA score in septic patients: incremental prognostic value over age, comorbidities, and parameters of sepsis severity. Intern Emerg Med. 2018;13:405–12
  25. Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, et al. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med. 2013;31(3):545–8.
  26. Duchnowski P, Hryniewiecki T, Kuśmierczyk M, Szymanski P. Red cell distribution width as a predictor of multiple organ dysfunction syndrome in patients undergoing heart valve surgery. Biol Open. 2018;7(10):bio036251.
  27. Wang AY, Ma HP, Kao WF, Tsai SH, Chang CK. Red blood cell distribution width is associated with mortality in elderly patients with sepsis. Am J Emerg Med. 2018;36(6):949–53.
  28. Ahlberg CD, Wallam S, Tirba LA, Itumba SN, Gorman L, Galiatsatos P. Linking Sepsis with chronic arterial hypertension, diabetes mellitus, and socioeconomic factors in the United States: A scoping review. J Crit Care [Internet]. 2023;77:154324
  29. Zhang L, Yu C hua, Guo K peng, Huang C zhi, Mo L ya. Prognostic role of red blood cell distribution width in patients with sepsis: a systematic review and meta-analysis. BMC Immunol. 2020;21(1):1–8
  30. Chen CK, Lin SC, Wu CC, Chen LM, Tzeng IS, Chen KF. STARD-compliant article: The utility of red cell distribution width to predict mortality for septic patients visiting the emergency department. Medicine (Baltimore). 2016;95(24).
  31. Kim S, Lee K, Kim I, Jung S, Kim MJ. Red cell distribution width and early mortality in elderly patients with severe sepsis and septic shock. Clin Exp Emerg Med. 2015;2(3):155.
  32. Vayá A, Sarnago A, Fuster O, Alis R, Romagnoli M. Influence of inflammatory and lipidic parameters on red blood cell distribution width in a healthy population. Clin Hemorheol Microcirc. 2015;59(4):379–85.
  33. Askar S, Deveboynu SN, Hilal ER, Askar TK, Hismiogullari AA. Changes in pro-inflammatory cytokines and antimicrobial proteins in elderly women with iron deficiency anemia. Pakistan J Med Sci. 2019;35(2):298.
  34. Santosa Q, Soemantri AG, Hadisaputro S, Soejoenoes A. Iron Status of Newborns and Umbilical Cord Blood Hepcidin Levels in Gender Differences. Jurnal Kedokteran Brawijaya. 2020 Feb 29;31(1):58-65.
  35. Yamaguchi J, Nagase M, Yamamoto Y, Sakurai A, Kubo A, Mitsuhashi H, et al. Increased oxidative stress and renal injury in patients with sepsis. J Clin Biochem Nutr. 2018;63(2):137–43.
  36. Subramani K, Raju SP, Chu X, Warren M, Pandya CD, Hoda N, et al. Effect of plasma-derived extracellular vesicles on erythrocyte deformability in polymicrobial sepsis. Int Immunopharmacol. 2018;65:244–7.
  37. Oh HJ, Park JT, Kim JK, Yoo DE, Kim SJ, Han SH, et al. Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patients treated with continuous renal replacement therapy. Nephrol Dial Transplant. 2012;27(2):589–94.
  38. Mangalesh S, Dudani S, Malik A. Platelet indices and their kinetics predict mortality in patients of sepsis. Indian J Hematol Blood Transfus. 2021;37(4):600–8.
  39. Tiro S, Samad R, Bahrun U. Platelet Count and Platelet Index as Prognosis Markers in Adult Septic Patients. Sepsis. 2019;2(3):37–80.
  40. Samuel D, Bhat AN, Prabhu VM. Platelet indices as predictive markers of prognosis in critically ill patients: a prospective study. Indian J Crit Care Med Peer-reviewed, Off Publ Indian Soc Crit Care Med. 2020;24(9):817.
  41. Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci. 2013;13(2):333–8.
  42. Khwannimit B, Bhurayanontachai R, Vattanavanit V. Comparison of the accuracy of three early warning scores with SOFA score for predicting mortality in adult sepsis and septic shock patients admitted to intensive care unit. Hear Lung [Internet]. 2019;48(3):240–4.
  43. Qiu X, Lei YP, Zhou RX. SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2023;21(8):891–900.
 

 

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