| 상부위장관 출혈 환자에서의 조기 고위험군 예측인자 및 사망예측 인자로서의 초기 적혈구 크기 분포 폭의 유용성: 예비 임상연구 |
| 김신영1, 김진용2, 이정훈3, 이경룡1, 홍대영1, 백광제1, 박상오1 |
1건국대학교 의학전문대학원 응급의학교실
2건국대학교 충주병원 응급의학과
3동국대학교 일산병원 응급의학과 |
| Efficacy of Red Cell Distribution Width as a Predictor of High Risk and Early Mortality in Upper Gastro-intestinal Bleeding: A Pilot Clinical Study |
| Sin Young Kim1, Jin Yong Kim2, Jung Hoon Lee3, Kyeong Ryong Lee1, Dae Young Hong1, Kwang Je Baek1, Sang O Park1 |
1Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Hospital, Seoul, Korea
2Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Chung-Ju Hospital, Chung-Ju, Korea
3Department of Emergency Medicine, School of Medicine, Dongkuk University, Dongguk University Ilsan Hospital, Gyeonggido, Korea |
| Correspondence |
Sang O Park ,Tel: 02) 2030-5551, Fax: 02) 2030-5780, Email: empso@kuh.ac.kr,
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Received: June 18, 2015; Revised: June 23, 2015 Accepted: October 1, 2015. Published online: December 30, 2015. |
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| ABSTRACT |
Purpose:
The aim of the study is to evaluate the efficacy of initial red cell distribution width (RDW) levels in the emergency department (ED) in predicting early 28-day mortality and high risk patients for early intervention in patients with upper gastrointestinal hemorrhage (UGIB).
Method:
This is a retrospective clinical study including UGIB patients in the ED. All data were collected through electronic medical records. The two major endpoints were early 28-day mortality and high risk patients. We assessed the relationship between initial RDW level and high risk patients and 28-day mortality.
Results:
A total of 198 patients were analyzed. There were 160 high risk patients (81.8%) and 12 non-survival patients (6.1%). The mean RDW value in high risk patients was higher than in non-risk patients (15.4±2.8 vs. 13.6±1.8%; p<0.0001). Area under curve (AUC) in Receiver-operatory characteristic (ROC) curve for RDW in high risk patients was 0.735 (95% Confidence Interval: 0.649-0.821; p<0.001) with an optimal cutoff value of 13.45% with sensitivity of 69.4% and specificity of 73.7%. The mean value of RDW in non-survivals was higher than in survivals (18.0±3.3 vs. 14.9±2.6 %; p<0.0001). AUC for RDW in predicting 28-day mortality was 0.793 (95% CI: 0.684-0.902; p<0.001) with an optimal cutoff value of 15.95% with sensitivity of 83.3% and specificity of 71.5%.
Conclusion:
RDW level in initial state might be helpful in predicting high risk patients for early intervention and 28-day mortality in UGIB in the ED. |
| Key words:
Erythrocyte indices, Gastrointestinal hemorrhage |
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