Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia

Nam Su Ku, Hye Won Kim, Hyung Jung Oh, Yong Chan Kim, Min Hyung Kim, Je Eun Song, Dong Hyun Oh, Jin Young Ahn, Sun Bean Kim, Su Jin Jeong, Sang Hoon Han, Chang Oh Kim, Young Goo Song, June Myung Kim, Jun Yong Choi

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Red blood cell distribution width (RDW) is known to be a predictor of severe morbidity and mortality in some chronic diseases such as congestive heart failure. However, to our knowledge, little is known about RDW as a predictor of mortality in patients with Gram-negative bacteremia, a major nosocomial cause of intra-abdominal infections, urinary tract infections, and primary bacteremia. Therefore, we investigated whether RDW is an independent predictor of mortality in patients with Gram-negative bacteremia. Clinical characteristics, laboratory parameters, and outcomes of 161 patients with Gram-negative bacteremia from November 2010 to March 2011 diagnosed at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, were retrospectively analyzed. The main outcome measure was 28-day all-cause mortality. The 28-day mortality rate was significantly higher in the increased RDW group compared with the normal RDW group (P < 0.001). According to multivariate Cox proportional hazard analysis, RDW levels at the onset of bacteremia (per 1% increase, P = 0.036), the Charlson index (per 1-point increase, P < 0.001), and the Sequential Organ Failure Assessment score (per 1-point increase, P = 0.001) were independent risk factors for 28-day mortality. Moreover, the nonsurvivor group had significantly higher RDW levels 72 h after the onset of bacteremia than did the survivor group (P = 0.001). In addition, the area under the curve of RDW at the onset of bacteremia, the 72-h RDW, and the Sequential Organ Failure Assessment score for 28-day mortality were 0.764 (P = 0.001), 0.802 (P < 0.001), and 0.703 (P = 0.008), respectively. Red blood cell distribution width at the onset of bacteremia was an independent predictor of mortality in patients with Gram-negative bacteremia. Also, 72-h RDW could be a predictor for all-cause mortality in patients with Gram-negative bacteremia.

Original languageEnglish
Pages (from-to)123-127
Number of pages5
JournalShock
Volume38
Issue number2
DOIs
Publication statusPublished - 2012 Aug 1

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Erythrocyte Indices
Bacteremia
Erythrocytes
Mortality
Organ Dysfunction Scores
Intraabdominal Infections
Korea
Urinary Tract Infections
Area Under Curve
Survivors
Chronic Disease
Heart Failure
Medicine
Outcome Assessment (Health Care)
Morbidity

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Ku, Nam Su ; Kim, Hye Won ; Oh, Hyung Jung ; Kim, Yong Chan ; Kim, Min Hyung ; Song, Je Eun ; Oh, Dong Hyun ; Ahn, Jin Young ; Kim, Sun Bean ; Jeong, Su Jin ; Han, Sang Hoon ; Kim, Chang Oh ; Song, Young Goo ; Kim, June Myung ; Choi, Jun Yong. / Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. In: Shock. 2012 ; Vol. 38, No. 2. pp. 123-127.
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abstract = "Red blood cell distribution width (RDW) is known to be a predictor of severe morbidity and mortality in some chronic diseases such as congestive heart failure. However, to our knowledge, little is known about RDW as a predictor of mortality in patients with Gram-negative bacteremia, a major nosocomial cause of intra-abdominal infections, urinary tract infections, and primary bacteremia. Therefore, we investigated whether RDW is an independent predictor of mortality in patients with Gram-negative bacteremia. Clinical characteristics, laboratory parameters, and outcomes of 161 patients with Gram-negative bacteremia from November 2010 to March 2011 diagnosed at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, were retrospectively analyzed. The main outcome measure was 28-day all-cause mortality. The 28-day mortality rate was significantly higher in the increased RDW group compared with the normal RDW group (P < 0.001). According to multivariate Cox proportional hazard analysis, RDW levels at the onset of bacteremia (per 1{\%} increase, P = 0.036), the Charlson index (per 1-point increase, P < 0.001), and the Sequential Organ Failure Assessment score (per 1-point increase, P = 0.001) were independent risk factors for 28-day mortality. Moreover, the nonsurvivor group had significantly higher RDW levels 72 h after the onset of bacteremia than did the survivor group (P = 0.001). In addition, the area under the curve of RDW at the onset of bacteremia, the 72-h RDW, and the Sequential Organ Failure Assessment score for 28-day mortality were 0.764 (P = 0.001), 0.802 (P < 0.001), and 0.703 (P = 0.008), respectively. Red blood cell distribution width at the onset of bacteremia was an independent predictor of mortality in patients with Gram-negative bacteremia. Also, 72-h RDW could be a predictor for all-cause mortality in patients with Gram-negative bacteremia.",
author = "Ku, {Nam Su} and Kim, {Hye Won} and Oh, {Hyung Jung} and Kim, {Yong Chan} and Kim, {Min Hyung} and Song, {Je Eun} and Oh, {Dong Hyun} and Ahn, {Jin Young} and Kim, {Sun Bean} and Jeong, {Su Jin} and Han, {Sang Hoon} and Kim, {Chang Oh} and Song, {Young Goo} and Kim, {June Myung} and Choi, {Jun Yong}",
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Ku, NS, Kim, HW, Oh, HJ, Kim, YC, Kim, MH, Song, JE, Oh, DH, Ahn, JY, Kim, SB, Jeong, SJ, Han, SH, Kim, CO, Song, YG, Kim, JM & Choi, JY 2012, 'Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia', Shock, vol. 38, no. 2, pp. 123-127. https://doi.org/10.1097/SHK.0b013e31825e2a85

Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. / Ku, Nam Su; Kim, Hye Won; Oh, Hyung Jung; Kim, Yong Chan; Kim, Min Hyung; Song, Je Eun; Oh, Dong Hyun; Ahn, Jin Young; Kim, Sun Bean; Jeong, Su Jin; Han, Sang Hoon; Kim, Chang Oh; Song, Young Goo; Kim, June Myung; Choi, Jun Yong.

In: Shock, Vol. 38, No. 2, 01.08.2012, p. 123-127.

Research output: Contribution to journalArticle

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AU - Ku, Nam Su

AU - Kim, Hye Won

AU - Oh, Hyung Jung

AU - Kim, Yong Chan

AU - Kim, Min Hyung

AU - Song, Je Eun

AU - Oh, Dong Hyun

AU - Ahn, Jin Young

AU - Kim, Sun Bean

AU - Jeong, Su Jin

AU - Han, Sang Hoon

AU - Kim, Chang Oh

AU - Song, Young Goo

AU - Kim, June Myung

AU - Choi, Jun Yong

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N2 - Red blood cell distribution width (RDW) is known to be a predictor of severe morbidity and mortality in some chronic diseases such as congestive heart failure. However, to our knowledge, little is known about RDW as a predictor of mortality in patients with Gram-negative bacteremia, a major nosocomial cause of intra-abdominal infections, urinary tract infections, and primary bacteremia. Therefore, we investigated whether RDW is an independent predictor of mortality in patients with Gram-negative bacteremia. Clinical characteristics, laboratory parameters, and outcomes of 161 patients with Gram-negative bacteremia from November 2010 to March 2011 diagnosed at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, were retrospectively analyzed. The main outcome measure was 28-day all-cause mortality. The 28-day mortality rate was significantly higher in the increased RDW group compared with the normal RDW group (P < 0.001). According to multivariate Cox proportional hazard analysis, RDW levels at the onset of bacteremia (per 1% increase, P = 0.036), the Charlson index (per 1-point increase, P < 0.001), and the Sequential Organ Failure Assessment score (per 1-point increase, P = 0.001) were independent risk factors for 28-day mortality. Moreover, the nonsurvivor group had significantly higher RDW levels 72 h after the onset of bacteremia than did the survivor group (P = 0.001). In addition, the area under the curve of RDW at the onset of bacteremia, the 72-h RDW, and the Sequential Organ Failure Assessment score for 28-day mortality were 0.764 (P = 0.001), 0.802 (P < 0.001), and 0.703 (P = 0.008), respectively. Red blood cell distribution width at the onset of bacteremia was an independent predictor of mortality in patients with Gram-negative bacteremia. Also, 72-h RDW could be a predictor for all-cause mortality in patients with Gram-negative bacteremia.

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