Red Cell Distribution Width in Correlation with Sequential Organ Failure Assessment Score as a Prognostic Marker of Sepsis

Aim: To determine the significance of red cell distribution width as prognostic marker in patients with sepsis. To assess the clinical outcome by correlating red cell distribution width with SOFA score in patient with sepsis.

Methods: This was a prospective study, which was conducted at tertiary care hospital , Pondicherry where we enrolled 71 patients above 18 years of age who had sepsis symptoms admitted in the medical ward/ICU. Patients with sepsis at admission were prospectively evaluated for correlation between RDW value, SOFA score both at admission , day 3 and day 7 with survivors and non-survivors. Besides the groups of raised and normal RDW, study population was further analyzed after categorizing into three RDW groups as follows: ≤14.2%, 14.2–15.2%, and >15.2% as well.

Results: 71 sepsis patient’s age ranged from 25 to 91 years with a mean age of 60.39 years. The male gender was predominant. The causes of sepsis were multifactorial and pneumonia was the prime cause of sepsis. 41-60 and 61-80 years were predominant age groups and equal number of major non- survivors were also belongs to this age groups (14.08% each). The RDW showed highly significant difference between survivors and non-survivors (P<0.0001). The mortality rate was highly significant in moderate and higher RDW groups (P<0.0001). While the RDW values increased, the mortality rate was also increased in the present study. There was a significant association between RDW levels and severity of sepsis that leads to mortality. Comparison of diagnostic accuracy of both RDW and SOFA at the time of admission showed that RDW had 100 % sensitivity and specificity whereas SOFA showed 100 % and 50 % sensitivity and specificity respectively.

Conclusion: By this study we could measure RDW value which is a part of an automated CBC which is a done routinely, which is cheap, easily available parameter on admission can be used as a prognostic marker in patients in sepsis.