title: Red cell distribution width and survival in patients hospitalized on a medical ICU.
abstract: OBJECTIVE
  Red cell distribution width was shown to reliably predict mortality and morbidity in numerous clinical settings, including patients hospitalized on surgical intensive care units (ICU). Patients hospitalized on an ICU usually comprise a very heterogeneous patient population. The aim of this analysis was to investigate whether (1) RDW is related to survival outcomes in patients hospitalized on a medical ICU and (2) the prognostic value of RDW is dependent on the diagnosis that led to ICU admission.
  
  
  METHODS
  829 patients hospitalized on the medical ICU of a tertiary care hospital were retrospectively investigated. Patients were divided in two groups according to the main diagnosis that led to ICU admission. Group 1: non-infectious cardiac disease and group 2: other. The prognostic value of RDW for ICU- and long-term mortality was investigated for the entire patient cohort as well as for the two subgroups.
  
  
  RESULTS
  The median RDW of the whole study population was 16.1%. Patients with an RDW above this threshold were exposed to an increased risk for ICU mortality (34.4% vs. 17.2%, p<0.001) and long-term mortality (log-rank p<0.001). Similarly, this cut-off was able to distinguish patients with an elevated risk for death in subgroup 2 (ICU mortality: 37.9% vs. 19.2%, p<0.001; long-term mortality: log-rank p<0.001). In subgroup 1, this value was not able to identify patients with an increased risk for ICU-mortality (17.6% vs. 11.8%, p=0.26) as well as long-term mortality (log-rank p=0.3).
  
  
  CONCLUSIONS
  Data of this analysis revealed that (1) RDW is a powerful predictor for ICU- and long-term mortality in patients hospitalized on a medical ICU and (2) RDW cut-offs to assess risk for death differ according to the main diagnosis that led to ICU admission.
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany. Electronic address: b.fujita@gmx.net.
authors.forename: Buntaro
authors.initials: B
authors.lastname: Fujita
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Franz
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Hans-Reiner
authors.initials: HR
authors.lastname: Figulla
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Ruediger
authors.initials: R
authors.lastname: Pfeifer
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Bjoern
authors.initials: B
authors.lastname: Kabisch
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Fritzenwanger
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
mesh_terms: D000368:Aged; D002423:Cause of Death; D004909:Erythrocyte Indices / Q000502:physiology*; D004912:Erythrocytes / Q000502:physiology*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Diagnosis; Medical ICU; RDW; Survival