Red cell distribution width and survival in patients hospitalized on a medical ICU
Red cell distribution width and survival in patients hospitalized on a medical ICU
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DOI：
10.1016/j.clinbiochem.2015.07.011
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发表时间：
2015-11-01
影响因子：
2.8
通讯作者：
Jung, Christian
中科院分区：
文献类型：
--
作者：
Fujita, Buntaro;Franz, Marcus;Jung, Christian
目的：红细胞分布宽度被证明可以可靠地预测许多临床环境中的死亡率和发病率，包括在外科重症监护病房（ICU）住院的患者。在ICU住院的患者通常包括非常异质的患者人群。本分析的目的是调查是否（1）RDW是相关的生存结果住院患者的医疗ICU和（2）RDW的预后价值是依赖于诊断，导致ICU accounting.Methods：829例患者住院的医疗ICU的三级保健医院进行了回顾性调查。根据导致ICU入院的主要诊断将患者分为两组。第1组：非感染性心脏病，第2组：其他。RDW对ICU和长期死亡率的预后价值进行了研究，为整个患者队列以及为两个subgroup.Results：整个研究人群的中位RDW为16.1%。RDW高于此阈值的患者ICU死亡率（34.4% vs. 17.2%，p < 0.001）和长期死亡率（对数秩p < 0.001）风险增加。同样，该临界值能够区分亚组2中死亡风险升高的患者（ICU死亡率：37.9% vs. 19.2%，p < 0.001;长期死亡率：对数秩p < 0.001）。在亚组1中，该值不能识别ICU死亡风险增加的患者（17.6%对11.8%，p = 0.26）以及长期死亡率（对数秩p = 0.3）。该分析的数据显示：（1）RDW是在内科ICU住院的患者的ICU和长期死亡率的有力预测因子;（2）RDW切根据导致ICU入院的主要诊断，评估死亡风险的风险不同。(C)2015年加拿大临床化学家协会。爱思唯尔公司出版All rights reserved.
Objectives: Red cell distribution width was shown to reliably predict mortality and morbidity in numerous clinical settings, including patients hospitalized on surgical intensive care units (ICU). Patients hospitalized on an ICU usually comprise a very heterogeneous patient population. The aim of this analysis was to investigate whether (1) RDW is related to survival outcomes inpatients hospitalized on a medical ICU and (2) the prognostic value of RDW is dependent on the diagnosis that led to ICU admission.Methods: 829 patients hospitalized on the medical ICU of a tertiary care hospital were retrospectively investigated. Patients were divided in two groups according to the main diagnosis that led to ICU admission. Group 1: non-infectious cardiac disease and group 2: other. The prognostic value of RDW for ICU- and long-term mortality was investigated for the entire patient cohort as well as for the two subgroups.Results: The median RDW of the whole study population was 16.1%. Patients with an RDW above this threshold were exposed to an increased risk for ICU mortality (34.4% vs. 17.2%, p < 0.001) and long-term mortality (log-rank p < 0.001). Similarly, this cut-off was able to distinguish patients with an elevated risk for death in subgroup 2 (ICU mortality: 37.9% vs. 19.2%, p < 0.001; long-term mortality: log-rank p < 0.001). In subgroup 1, this value was not able to identify patients with an increased risk for ICU-mortality (17.6% vs. 11.8%, p = 026) as well as long-term mortality (log-rank p = 0.3).Conclusions: Data of this analysis revealed that (1) RDW is a powerful predictor for ICU- and long-term mortality in patients hospitalized on a medical ICU and (2) RDW cut-offs to assess risk for death differ according to the main diagnosis that led to ICU admission. (C) 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.