Red cell distribution width as a predictor of mortality in organophosphate insecticide poisoning.
OBJECTIVE
Suicide by organophosphate insecticide (OPI) poisoning is a major clinical concern (predominantly in developing countries), and 200000 deaths occur annually worldwide. Red cell distribution width (RDW) has been used to predict outcome in several clinical conditions. Here, we aimed to investigate the relationship between the RDW and 30-day mortality during OPI poisoning.


METHODS
This retrospective analysis was performed between January 2008 and July 2013 in patients admitted to the emergency department after OPI poisoning. A Kaplan-Meier 30-day survival curve was analyzed in patients stratified according to the optimal cut-off point of RDW defined using a receiver operating characteristic (ROC) curve. Multivariate Cox proportional hazards analyses were conducted to determine the independent prognostic factors for 30-day mortality.


RESULTS
Among 102 patients, 21 died, yielding a mortality of 20.6%. Elevated RDW was significantly associated with early mortality in patients with OPI poisoning. Levels of RDW that exceeded 13.5% (hazard ratio, 2.64; 95% confidence interval [CI], 1.05-6.60) were associated with increased mortality in the multivariate analysis. The area under the ROC curve of RDW was 0.675 (95% CI, 0.522-0.829).


CONCLUSIONS
This study showed that RDW is an independent predictor of 30-day mortality in patients with OPI poisoning.
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Changwoo
C
Kang
Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea. Electronic address: gnuhpis@gnu.ac.kr.
In Sung
IS
Park
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Dong Hoon
DH
Kim
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Seong Chun
SC
Kim
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Jin Hee
JH
Jeong
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Soo Hoon
SH
Lee
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Sang Bong
SB
Lee
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Sang Min
SM
Jung
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Tae-Sin
TS
Kang
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Kyung-Woo
KW
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062025:Organophosphate Poisoning / Q000097:blood* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies
D007306:Insecticides