Correlation of red cell distribution width with prognosis in patients with severe traumatic brain injury / 中华创伤杂志

ABSTRACT

Objective To investigate the correlation between red cell distribution width RDW) and prognosis in patients with severe traumatic brain injury.Methods A total of 264 consecutive patients with severe traumatic brain injury admitted from May 2012 to November 2014 were enrolled.The patients were divided into low-RDW group (RDW ＜ 15％,n =198) and high-RDW group (RDW ≥ 15％,n =66) based on their RDW levels.Between-group differences were evaluated on general conditions,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),inflammatory markers [high sensitivity C-reactive proteins(hs-CRP) and arterial lactate],liver/renal dysfunction,and 28-day mortality.Spearman correlation analysis of RDW with mortality was conducted.Independent factors of 28-day mortality were identified using multivariate Logistic regression.Kaplan-Meier 28-day survival curve was analyzed and survival probability of the two groups was compared using Log-Rank test.Results The 28-day mortality was significantly enhanced in high-RDW group compared to that in lowRDW group (43.9％ vs 26.8％,P ＜ 0.01).RDW ≥ 15％ related positively to APACHE Ⅱ and mortality(r =0.172 and 0.253 respectively,P ＜ 0.01),but negatively to Glagow coma score (GCS) (r =-0.169,P ＜0.01).RDW≥ 15％ was the independent risk factor for predicting the 28-day mortality (OR =2.144,95％ CI 1.202-3.826,P ＜0.01).After adjusted gender,age,and other relative factors,RDW≥15％ was still strongly correlated with the 28-day mortality(OR =2.244,95％ CI 1.076-4.678,P ＜ 0.05).Significantly lower 28-day survival rate was found in high-RDW group than in low-RDW group (P ＜ 0.01).Conclusions RDW level rises beyond the normal range on admission in patients with severe traumatic brain injury,which is closely correlated with the 28-day poor outcome.RDW≥ 15％ has significant predictive value in the prognosis.