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J Korean Soc Emerg Med > Volume 28(3); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(3): 255-262.
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,
Received: March 31, 2017; Revised: April 3, 2017   Accepted: June 1, 2017.  Published online: June 30, 2017.
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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