Predictive value of red cell distribution width on the prognosis of patients with abdominal sepsis / 中华危重病急救医学

ABSTRACT

Objective To approach the value of red cell distribution width (RDW) on the prognostic assessment of patients with abdominal sepsis. Methods The clinical data of adult patients with abdominal sepsis admitted to intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to September 2017 were retrospectively analyzed. The patients were divided into survival group and death group according to ICU prognosis. The levels of serum lactate (Lac), procalcitonin (PCT), RDW, and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score within 24 hours were recorded. Receiver operating characteristic (ROC) curve was plotted to analyze the prognostic value of Lac, PCT, RDW and APACHE Ⅱ score. Results 162 patients with abdominal sepsis were enrolled, 132 survived, and 30 died. Compared with survival group, the Lac, PCT, APACHE Ⅱ score, and RDW in death group were significantly increased [Lac (mmol/L) 4.21±2.42 vs. 2.27±1.51, PCT (mg/L) 32.08±12.95 vs. 11.87±8.81, APACHEⅡ score 30.13±6.42 vs. 23.36±5.29, RDW (16.64±1.38)% vs. (13.49±2.03)%, all P < 0.01]. ROC curve analysis showed that all indicators could be used to predict the prognosis of abdominal sepsis, with the maximum predictive value of RDW. The area under the ROC curve (AUC) was 0.888, it was greater than that of APACHE Ⅱ score (AUC = 0.787), Lac (AUC = 0.767) and PCT (AUC = 0.696). When threshold value of RDW was 15.40%, the sensitivity was 83.3%, and the specificity was 85.6%. Conclusion RDW can evaluate the prognosis of patients with abdominal sepsis, and its predictive value is greater than traditional evaluation parameters such as APACHEⅡscore, Lac, and PCT.