Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia.
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.
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Nam Su
NS
Ku
Hye-Won
HW
Kim
Hyung Jung
HJ
Oh
Yong Chan
YC
Kim
Min Hyung
MH
Kim
Je Eun
JE
Song
Dong Hyun
DH
Oh
Jin Young
JY
Ahn
Sun Bean
SB
Kim
Su Jin
SJ
Jeong
Sang Hoon
SH
Han
Chang Oh
CO
Kim
Young Goo
YG
Song
June Myung
JM
Kim
Jun Yong
JY
Choi
D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D004913:Erythrocytes, Abnormal / Q000382:microbiology / Q000473:pathology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors