DOI: https://doi.org/10.14710/jai.v0i0.60298

Correlation Between Red Cell Distribution Width (RDW) and Sequential Organ Failure Assessment (SOFA) Score in Sepsis Patients

1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Sumatera Utara University/Rumah Sakit Umum Pusat Haji Adam Malik, Medan, Indonesia

2Faculty of Medicine, Sumatera Utara University, Medan, Indonesia

Received: 6 Dec 2023; Revised: 22 Mar 2024; Accepted: 22 Mar 2024; Available online: 22 Mar 2024; Published: 31 Jul 2024.
Open Access Copyright 2024 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Background: There are an estimated 31.5 million cases of sepsis per year, and approximately 61% end up in sepsis shock, with a potential mortality rate of 5.3 million per year. In addition to the sequential organ failure assessment (SOFA) score, several biomarkers have been used to assess severity and predict mortality, including red cell distribution width (RDW). RDW is increased in conditions of ineffective red blood cell production or destruction that occur in inflammation or infection. RDW above 15.5% is associated with rigid and indestructible red blood cells, which can impede microcirculation and contribute to organ dysfunction, a part of the SOFA score.

Objective: The aim of this study was to determine the correlation between RDW and SOFA score in sepsis patients admitted to the intensive care unit (ICU) of Rumah Sakit Umum Pusat Haji Adam Malik Medan.

Methods: This study used a cohort-prospective study design with a consecutive sampling technique of the population that met the inclusion criteria. The samples were sepsis patients who were admitted to the ICU of Rumah Sakit Umum Pusat Haji Adam Malik Medan in April–June 2023. The data was analyzed by a Pearson or Spearman analysis test.

Result: There was a significant correlation between RDW and SOFA score (r = 0.471; p<0.05) in ICU sepsis patients. There was a significant correlation (p = 0.003) between RDW values and SOFA scores on the third day, where there was a moderate degree of correlation (r = 0.471), but there was no significant correlation (p = 0.103) between RDW values and SOFA scores on the first day. The sensitivity, specificity, and cut-off values of RDW were found to be 76.5%, 75%, and 14.75%, which compared to SOFA were 76.5%, 75%, and 10.5.

Conclusion: There is a statistically significant relationship between RDW and SOFA, with a moderate correlation.

Note: This article has supplementary file(s).

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Subject ICU, RDW, Sepsis, SOFA Score
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Keywords: ICU; infection; RDW; sepsis; SOFA score

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Language : EN
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  1. Ling J, Liao T, Wu Y, Wang Z, Jin H, Lu F, et al. Predictive value of red blood cell distribution width in septic shock patients with thrombocytopenia: A retrospective study using machine learning. J Clin Lab Anal. 2021;35(12):1–9
  2. Zorlu A, Bektasoglu G, Guven FMK, Dogan OT, Gucuk E, Ege MR, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol. United States; 2012 Jan;109(1):128–34
  3. Hodeib M, Morgan D, Hedaya A, Waked N. A study of elevated red cell distribution width (RDW) in early-onset neonatal sepsis. Egypt Pediatr Assoc Gaz [Internet]. 2022;70(1):21. Available from: https://doi.org/10.1186/s43054-022-00112-3
  4. 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. United States; 2014;9(8):e105436
  5. Xu J, Tong L, Yao J, Guo Z, Lui KY, Hu X, et al. Association of Sex With Clinical Outcome in Critically Ill Sepsis Patients: A Retrospective Analysis of the Large Clinical Database MIMIC-III. Shock. United States; 2019 Aug;52(2):146–51
  6. Yuan K-C, Tsai L-W, Lee K-H, Cheng Y-W, Hsu S-C, Lo Y-S, et al. The development an artificial intelligence algorithm for early sepsis diagnosis in the intensive care unit. Int J Med Inform. Ireland; 2020 Sep;141:104176
  7. Feng Q, Ai Y-H, Gong H, Wu L, Ai M-L, Deng S-Y, et al. Characterization of Sepsis and Sepsis-Associated Encephalopathy. J Intensive Care Med. United States; 2019;34(11–12):938–45
  8. Zhou J, Tian H, Du X, Xi X, An Y, Duan M, et al. Population-Based Epidemiology of Sepsis in a Subdistrict of Beijing. Crit Care Med. United States; 2017 Jul;45(7):1168–76
  9. Fathi M, Markazi-Moghaddam N, Ramezankhani A. A systematic review on risk factors associated with sepsis in patients admitted to intensive care units. Aust Crit care Off J Confed Aust Crit Care Nurses. Australia; 2019 Mar;32(2):155–64
  10. Thompson KJ, Finfer SR, Woodward M, Leong RNF, Liu B. Sex differences in sepsis hospitalisations and outcomes in older women and men: A prospective cohort study. J Infect. England; 2022 Jun;84(6):770–6
  11. Li S, Hu X, Xu J, Huang F, Guo Z, Tong L, et al. Increased body mass index linked to greater short- and long-term survival in sepsis patients: A retrospective analysis of a large clinical database. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. Canada; 2019 Oct;87:109–16
  12. Sakr Y, Jaschinski U, Wittebole X, Szakmany T, Lipman J, Ñamendys-Silva SA, et al. Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit. Open forum Infect Dis. United States; 2018 Dec;5(12):ofy313
  13. Jiang Y, Jiang F-Q, Kong F, An M-M, Jin B-B, 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. Germany; 2019 Jun;9(1):67
  14. Wang A-Y, Ma H-P, Kao W-F, Tsai S-H, Chang C-K. Red blood cell distribution width is associated with mortality in elderly patients with sepsis. Am J Emerg Med. United States; 2018 Jun;36(6):949–53
  15. 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. England; 2013 Dec;17(6):R282
  16. Van Breda F, Emans ME, van der Putten K, Braam B, van Ittersum FJ, Kraaijenhagen RJ, et al. Relation between Red Cell Distribution Width and Fibroblast Growth Factor 23 Cleaving in Patients with Chronic Kidney Disease and Heart Failure. PLoS One. United States; 2015;10(6):e0128994
  17. Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, et al. Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit. JAMA. United States; 2017 Jan;317(3):290–300
  18. 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. Italy; 2018 Apr;13(3):405–12
  19. Yu S, Leung S, Heo M, Soto GJ, Shah RT, Gunda S, et al. Comparison of risk prediction scoring systems for ward patients: a retrospective nested case-control study. Crit Care. England; 2014 Jun;18(3):R132
  20. Wang J-Y, Chen Y-X, Guo S-B, Mei X, Yang P. Predictive performance of quick Sepsis-related Organ Failure Assessment for mortality and ICU admission in patients with infection at the ED. Am J Emerg Med. United States; 2016 Sep;34(9):1788–93
  21. Nurtadjudin LMK, Handayani I, Abdullah AA, Arif M. The Correlation between RDW, PDW, and NLR with the SOFA Score in Septic Patients. Indones J Clin Pathol Med Lab [Internet]. 2023 Jan 19;29(1 SE-Articles):6–10. Available from: https://www.indonesianjournalofclinicalpathology.org/index.php/patologi/article/view/1960
  22. Jing J-S, Fu X-L, Zhao W, Kong L-B. Red Cell Distribution Width as a Prognostic Factor in Patients with Hepatocellular Carcinoma. Clin Lab. Germany; 2020 Jul;66(7)
  23. Zhang L, Yu C-H, Guo K-P, Huang C-Z, Mo L-Y. Prognostic role of red blood cell distribution width in patients with sepsis: a systematic review and meta-analysis. BMC Immunol. England; 2020 Jul;21(1):40
  24. Peng Y, Guan X, Wang J, Ma J. Red cell distribution width is correlated with all-cause mortality of patients in the coronary care unit. J Int Med Res. England; 2020 Jul;48(7):300060520941317
  25. Ju X-F, Wang F, Wang L, Wu X, Jiang T-T, You D-L, et al. Dynamic Change of Red Cell Distribution Width Levels in Prediction of Hospital Mortality in Chinese Elderly Patients with Septic Shock. Chin Med J (Engl). China; 2017 May;130(10):1189–95
  26. Fontana V, Spadaro S, Bond O, Cavicchi FZ, Annoni F, Donadello K, et al. No relationship between red blood cell distribution width and microcirculatory alterations in septic patients. Clin Hemorheol Microcirc. Netherlands; 2017;66(2):131–41
  27. Han Y-Q, Zhang L, Yan L, Li P, Ouyang P-H, Lippi G, et al. Red blood cell distribution width predicts long-term outcomes in sepsis patients admitted to the intensive care unit. Clin Chim Acta. Netherlands; 2018 Dec;487:112–6
  28. Karakike E, Kyriazopoulou E, Tsangaris I, Routsi C, Vincent J-L, Giamarellos-Bourboulis EJ. The early change of SOFA score as a prognostic marker of 28-day sepsis mortality: analysis through a derivation and a validation cohort. Crit Care. England; 2019 Nov;23(1):387
  29. Li Y, Yan C, Gan Z, Xi X, Tan Z, Li J, et al. Prognostic values of SOFA score, qSOFA score, and LODS score for patients with sepsis. Ann Palliat Med. China; 2020 May;9(3):1037–44

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