Red Cell Distribution Width at Admission Predicts the Frequency of Acute Kidney Injury and 28-Day Mortality in Patients With Acute Respiratory Distress Syndrome. Issue 3 (11th March 2022)

• Record Type: Journal Article
• Authors: Cai, Nan; Jiang, Min; Wu, Chao; He, Fei
• Is Part Of: Shock. Volume 57:Issue 3(2022)
• Page Start: 370
• Page End: 377
• Publication Date: 2022-03-11
• Subjects: Acute kidney injury -- acute respiratory distress syndrome -- mortality -- red cell distribution width; AKI -- acute kidney injury -- APACHE II -- acute physiology and chronic health evaluation II -- ARDS -- acute respiratory distress syndrome -- AUC -- area under curve -- BUN -- blood urea nitrogen -- CI -- confidence interval -- COPD -- chronic obstructive pulmonary disease -- CRP -- C-reactive protein -- CRRT -- continuous renal replacement therapy -- eGFR -- estimated glomerular filtration rate -- EICU -- emergency intensive care unit -- HRs -- hazard ratios -- ICU -- intensive care units -- IMV -- invasive mechanical ventilation -- IQR -- interquartile ranges -- KDIGO -- kidney disease improving global outcomes -- LR -- likelihood ratio -- NLR -- neutrophil to lymphocyte ratio -- OR -- odds ratio -- PaO2/FiO2 -- partial pressure of arterial oxygen to the fraction of inspired oxygen -- PCT -- procalcitonin -- RDW -- red cell volume distribution width -- ROC -- receiver operating characteristic curve -- SCr -- serum creatinine -- SD -- standard deviation -- SOFA -- sequential organ failure assessment -- UA -- uric acid -- WBC -- white blood cell; Shock -- Periodicals; Shock -- Periodicals; Choc (Pathologie) -- Périodiques; Shock; Periodicals; 616.0475
• DOI: 10.1097/SHK.0000000000001840
• Languages: English
• ISSNs: 1073-2322

Abstract

ABSTRACT: Objectives: To determine the association of red cell distribution width (RDW) at admission with frequency of acute kidney injury (AKI) and 28-day mortality in acute respiratory distress syndrome (ARDS) patients. Methods: Two hundred fifty-eight ARDS patients were investigated in retrospective and prospective studies. The primary outcome was frequency of AKI. The secondary outcome was 28-day mortality. Results: The retrospective study included 193 ARDS patients, of which 67 (34.7%) were confirmed AKI and 76 (39.4%) died within 28 days. The RDW level in the AKI group was significantly higher than in the non-AKI group ([15.15 ± 2.59]% vs. [13.95 ± 1.89]%). Increased RDW was a significant predictor of frequency of AKI (odds ratio: 1.247, 95% confidence interval [CI]: 1.044, 1.489). The area under the receiver operating characteristic curve of RDW for predicting AKI was 0.687 (95%CI: 0.610, 0.764) and the cut-off value was 14.45 (sensitivity, 56.7%; specificity, 72.8%). In addition, the proportion of patients with RDW ≥ 14.45% in the non-survival group was notably higher compared with the survival group (48.7% vs. 29.1%). Furthermore, cox regression analysis revealed that RDW ≥ 14.45% was associated with 28-day mortality (hazard ratio: 1.817, 95%CI: 1.046, 3.158), while Kaplan–Meier analysis showed patients with RDW ≥ 14.45% had a significantly lower survival rate than those with RDW < 14.45%. The prospective study, on the other hand, included 65 ARDS patients, with frequency of AKI and 28-day mortality in the RDW ≥ 14.45% group significantly higher than in RDW < 14.45%. Conclusion: RDW was a significant, independent predictor for frequency of AKI and 28-day mortality in ARDS patients.