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J Korean Soc Emerg Med > Volume 27(6); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(6): 505-513.
응급실에 내원한 중증 외상 환자에서 예후 예측을 위한 초기 적혈구 크기 분포 폭의 유용성
박용석, 서강석, 박정배, 이미진, 류현욱, 문성배, 김종근, 이동언, 안재윤
경북대학교 의학전문대학원 응급의학교실
Usefulness of Initial Red Cell Distribution Width for Predicting Mortality in Severe Trauma Patients Admitted to the Emergency Department
Yong Seok Park, Kang Suk Seo, Jung Bae Park, Mi Jin Lee, Hyun Wook Ryoo, Sungbae Moon, Jong Kun Kim, Dong Eun Lee, Jae Yun Ahn
Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
Correspondence  Jae Yun Ahn ,Tel: 053-420-6400, Fax: 053-428-2820, Email: portnoy27@hanmail.net,
Received: June 29, 2016; Revised: June 30, 2016   Accepted: September 26, 2016.  Published online: December 31, 2016.
This study investigated the association between the initial red cell distribution width (RDW) and mortality in patients with severe trauma.
We conducted a retrospective analysis between January and December 2014. Severe adult trauma patients (age ≥18, Injury Severity Score≥16), who were treated in our emergency department, were included in this study. We classified patients into four groups in accordance with their RDW (group 1: RDW≤12.3%, group 2: 12.4%≤RDW≤12.6%, group 3: 12.7%≤RDW≤13.2%, group 4: 13.3%≤RDW). They were compared based on the characteristics of their groups. We also compared the baseline characteristics of patients who survived and did not survive. Univariate and multivariate Cox proportional hazard analyses were performed to determine the association between mortality and each variable.
We enrolled 364 severe trauma adult patients. The mortality rate was 8.9%, 16.2%, 12.6%, and 20.4% for RDW groups 1, 2, 3, and 4, respectively; there was no statistical significance. The RDW of patients who survived (n=311) and did not survive (n=53) were 12.7% (12.4-13.3%) and 12.9% (12.5-13.6%), respectively, but this was also not statistically significant (p=0.075). Univariate Cox proportional hazard analysis showed a significant difference between the mortality and initial RDW, but a multivariate analysis did not show an independent association between initial RDW and mortality (hazard ratio, 0.729; confidence interval, 0.508-1.047; p=0.087). Moreover, multivariate analysis did not also show a significant difference between RDW quartile groups according to route of hospital visit.
There was no independent association between the initial RDW and mortality in patients with severe trauma.
Key words: Adult, Mortality, Red cell distribution width, Trauma
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