title: Red cell distribution width is an independent predictor of mortality in necrotizing fasciitis.
abstract: BACKGROUND
  Necrotizing fasciitis (NF) is a rapidly progressing and potentially lethal infectious disease of the soft tissue. An elevated red blood cell distribution width (RDW) is associated with increased risk of death in patients with heart disease and infectious disease. We retrospectively assessed the association of elevated RDW with in-hospital mortality due to NF.
  
  
  METHODS
  All patients had diagnoses of NF and were admitted to the emergency department of a single institution in Taiwan over a 4-year period. Demographics, comorbidities, clinical presentations, and laboratory parameters were retrospectively reviewed. Red blood cell distribution width was categorized as elevated (>14.5%) or not elevated. Multivariate regression analysis was used to identify risk factors associated with mortality.
  
  
  RESULTS
  A total of 98 patients were enrolled, and the mortality rate was 23%. Univariate analysis indicated that advanced age, initial hypotension, low hemoglobin level, and elevated RDW (69.6% vs 20%, OR = 9.14, P < .001) were significantly associated with mortality. Multivariate analysis indicated that RDW was a significant and independent predictor of mortality in enrolled patients.
  
  
  CONCLUSIONS
  Elevated RDW is a significant and independent predictor of in-hospital mortality for patients with NF.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: dr8951@cgmh.org.tw.
authors.forename: Chia-Lung
authors.initials: CL
authors.lastname: Weng
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: Hatalove@cgmh.org.tw.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: giomacky@gmail.com.
authors.forename: I-Chuan
authors.initials: IC
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: richard_smith@mail2000.com.tw.
authors.forename: Kuang-Yu
authors.initials: KY
authors.lastname: Hsiao
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: neoego@adm.cgmh.org.tw.
authors.forename: Kung-Pin
authors.initials: KP
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: swing.orz@hotmail.com.
authors.forename: Shih-Yun
authors.initials: SY
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taiwan (ROC). Electronic address: homoe042002@hotmail.com.
authors.forename: Hong-Mo
authors.initials: HM
authors.lastname: Shih
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004909:Erythrocyte Indices; D019115:Fasciitis, Necrotizing / Q000097:blood* / Q000150:complications / Q000401:mortality; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D017052:Hospital Mortality; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D006454:Hemoglobins