| 응급실로 내원한 패혈증 환자에서 예후예측 인자로서의 적혈구 크기 분포 폭의 유용성 |
| 이성, 홍대영, 김종원, 김신영, 박상오, 이경룡, 백광제, 김진용 |
| 건국대학교 의학전문대학원 응급의학교실 |
| Efficacy of Red Cell Distribution Width as Prognostic Factor for Sepsis-3 Patients in Emergency Department |
| Sung Lee, Dae Young Hong, Jong Won Kim, Sin Young Kim, Sang O Park, Kyeong Ryong Lee, Kwang Je Baek, Jin Yong Kim |
| Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea |
| Correspondence |
Jin Yong Kim ,Tel: 043-840-8332, Fax: 043-840-8962, Email: palenova@naver.com,
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Received: March 31, 2017; Revised: April 3, 2017 Accepted: June 1, 2017. Published online: June 30, 2017. |
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| ABSTRACT |
Purpose:
Red cell distribution width (RDW) was introduced as a new biomarker for the prognosis of sepsis patients. In addition, the definition of sepsis has changed recently to sepsis-3 criteria. The aim of this study was to compare the efficacy of RDW as a prognostic factor for sepsis-3 patients in the emergency department.
Method:
We conducted a retrospective study of patients who were suspected of having sepsis between October, 2015 and April, 2016. The demographic data, comorbidities, blood test results, including RDW, lactate, C-reactive protein, and procalcitonin at admission, as well as the Mortality in Emergency Department Sepsis score were compared between the 30-day survivors and nonsurvivors. Analysis compared the areas under the receiver operator characteristic curves for 30-day mortality. Multivariate Cox proportional hazards regression analysis was performed to determine the risk factors for mortality.
Results:
A total of 222 patients were included. The mean age was 75, 51.8% of the patient population was male, and the overall mortality rate was 16.7%. The non-survival group had higher RDW levels than the survivor group (14.5% vs 13.4%). The area under the receiver operating characteristic curve of RDW to predict mortality was 0.724. In a Cox proportional hazards analysis, RDW had 1.292 hazard ratio. Setting the RDW cutoff value to 14.3, we found that sensitivity and specificity of predicting mortality was 75.1% and 70.3%, respectively.
Conclusion:
It may be possible to use RDW to predict mortality in sepsis-3 patients. |
| Key words:
Sepsis, Red blood cell, Prognosis, Mortality, Emergency departments |
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