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DOI: 10.1055/s-0041-1730883
Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit
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Abstract
Introduction The red blood cell distribution width (RDW) is a measurement of variations in the size of red blood cells. As the width increases, the rate of mortality also increases, although the reason for it is still not known. On the other hand, platelet distribution width (PDW) is also useful in predicting morbidity and mortality in sepsis and other critically ill patients. In our study, we planned to study the impact of both RDW and PDW and evaluate their prognostic importance with outcome in patients admitted in medicine intensive care unit (MICU).
Material and Method In these cross-sectional observational studies, 1,300 patients were included who were admitted in MICU. Critically ill patients were defined on the basis of qSOFA score greater than 2. PDW and RDW were obtained from Coulter report of complete blood count. Parameters included in Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were taken and APACHE IV score was calculated. Correlation of RDW and PDW with outcomes such as length of ICU stay, use of mechanical ventilator, and discharge/death was done.
Result The mean RDW (%) for the entire study population was 15.17 ± 3.01. The RDW (%) was significantly on the higher side in patients who succumbed to the disease as compared with the patients who were discharged. The correlation between the length of ICU stay (days) and RDW (%) was moderately positive and was significant (rho = 0.37, p ≤ 0.001). The correlation between the length of ICU stay (days) and PDW (%) was moderately positive and was significant (rho = 0.5, p ≤ 0.001).
Conclusion RDW and PDW were found as significant indicators for period of stay in ICU, requirement for mechanical ventilation, and mortality rate in patients admitted to ICUs. As these are simple, easy to conduct, universally available tests, they can be regularly incorporated in patients admitted in ICUs.
Keywords
red cell distribution width - platelet distribution width - mortality - morbidity - critically illPublikationsverlauf
Artikel online veröffentlicht:
26. Juni 2021
© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Lippi G, Plebani M. Red blood cell distribution width (RDW) and human pathology. One size fits all. Clin Chem Lab Med 2014; 52 (09) 1247-1249
- 2 Kaito K, Otsubo H, Usui N. et al Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol 2005; 128 (05) 698-702
- 3 Zhang S, Cui Y-L, Diao M-Y, Chen D-C, Lin Z-F. Use of platelet indices for determining illness severity and predicting prognosis in critically ill patients. Chin Med J (Engl) 2015; 128 (15) 2012-2018
- 4 Montagnana M, Cervellin G, Meschi T, Lippi G. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med 2011; 50 (04) 635-641
- 5 Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between red cell distribution width and clinical outcomes after acute myocardial infarction. Am J Cardiol 2010; 105 (03) 312-317
- 6 Pascual-Figal DA, Bonaque JC, Redondo B. et al Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients. Eur J Heart Fail 2009; 11 (09) 840-846
- 7 Braun E, Domany E, Kenig Y, Mazor Y, Makhoul BF, Azzam ZS. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia. Crit Care 2011; 15 (04) R194
- 8 Hampole CV, Mehrotra AK, Thenappan T, Gomberg-Maitland M, Shah SJ. Usefulness of red cell distribution width as a prognostic marker in pulmonary hypertension. Am J Cardiol 2009; 104 (06) 868-872
- 9 Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009; 169 (05) 515-523
- 10 Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients. Crit Care Med 2011; 39 (08) 1913-1921
- 11 Babu E, Basu D. Platelet large cell ratio in the differential diagnosis of abnormal platelet counts. Indian J Pathol Microbiol 2004; 47 (02) 202-205
- 12 Artunc Ulkumen B, Pala HG, Calik E, Oruc Koltan S. Platelet distribution width (PDW): a putative marker for threatened preterm labour. Pak J Med Sci 2014; 30 (04) 745-748
- 13 Erez O, Romero R, Hoppensteadt D. et al Premature labor: a state of platelet activation?. J Perinat Med 2008; 36 (05) 377-387
- 14 Ulucan Ş, Keser A, Kaya Z. et al Association between PDW and long term major adverse cardiac events in patients with acute coronary syndrome. Heart Lung Circ 2016; 25 (01) 29-34
- 15 Ahmad MS, Waheed A. Platelet counts, MPV and PDW in culture proven and probable neonatal sepsis and association of platelet counts with mortality rate. J Coll Physicians Surg Pak 2014; 24 (05) 340-344
- 16 Pal A, Prashant K. An audit on pattern of mortality in a medicine ICU at tertiary care hospital of North-East India. Int J Med Biomed Stud 2020; 4 (02) 199-201
- 17 Madani TA, Ghabrah TM, Albarrak AM. et al Causes of admission to intensive care units in the Hajj period of the Islamic year 1424 (2004). Ann Saudi Med 2007; 27 (02) 101-105
- 18 McManus DD, Nguyen HL, Saczynski JS, Tisminetzky M, Bourell P, Goldberg RJ. Multiple cardiovascular comorbidities and acute myocardial infarction: temporal trends (1990-2007) and impact on death rates at 30 days and 1 year. Clin Epidemiol 2012; 4: 115-123
- 19 Hoffmann JJ, Nabbe KCAM, van den Broek NMA. Effect of age and gender on reference intervals of red blood cell distribution width (RDW) and mean red cell volume (MCV). Clin Chem Lab Med 2015; 53 (12) 2015-2019
- 20 Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009; 169 (06) 588-594
- 21 Şenol K, Saylam B, Kocaay F, Tez M. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med 2013; 31 (04) 687-689
- 22 Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci 2009; 277 (1-2) 103-108
- 23 Farzanegan B, Zangi M. Predictor factors for sepsis diagnosis, length of ICU stay and mortality in ICU. J Cell Mol Anesth 2017; 2 (02) 55-62
- 24 Tonietto TA, Boniatti MM, Lisboa TC. et al Elevated red blood cell distribution width at ICU discharge is associated with readmission to the intensive care unit. Clin Biochem 2018; 55: 15-20
- 25 Fujita B, Strodthoff D, Fritzenwanger M. et al Altered red blood cell distribution width in overweight adolescents and its association with markers of inflammation. Pediatr Obes 2013; 8 (05) 385-391
- 26 Otero TM, Canales C, Yeh DD, Hou PC, Belcher DM, Quraishi SA. Elevated red cell distribution width at initiation of critical care is associated with mortality in surgical intensive care unit patients. J Crit Care 2016; 34: 7-11
- 27 Meynaar IA, Knook AHM, Coolen S. et al Red cell distribution width as predictor for mortality in critically ill patients. Neth J Med 2013; 71 (09) 488-493
- 28 Aydogan A, Akkucuk S, Arica S. et al The analysis of mean platelet volume and platelet distribution width levels in appendicitis. Indian J Surg 2015; 77 (Suppl. 02) 495-500
- 29 Ren X, Meng Z, Liu M. et al No associations exist between mean platelet volume or platelet distribution width and thyroid function in Chinese. Medicine (Baltimore) 2016; 95 (40) e4573
- 30 Hoffmann JJ, van den Broek NMA, Curvers J. Reference intervals of reticulated platelets and other platelet parameters and their associations. Arch Pathol Lab Med 2013; 137 (11) 1635-1640
- 31 Zhang Z, Xu X, Ni H, Deng H. Platelet indices are novel predictors of hospital mortality in intensive care unit patients. J Crit Care 2014; 29 (05) 885.e1-885.e6
- 32 Simani L, Oroei M, Sadeghi H. et al Platelet indices for predicting patient outcomes in post-neurosurgical meningitis. Arch Neurosci 2019; 6 (02) e82911
- 33 Gao Y, Li Y, Yu X. et al The impact of various platelet indices as prognostic markers of septic shock. PLoS ONE 2014; 9 (08) e103761
- 34 Sezgi C, Taylan M, Kaya H. et al Alterations in platelet count and mean platelet volume as predictors of patient outcome in the respiratory intensive care unit. Clin Respir J 2015; 9 (04) 403-408
- 35 Tzur I, Barchel D, Izhakian S. et al Platelet distribution width: a novel prognostic marker in an internal medicine ward. J Community Hosp Intern Med Perspect 2019; 9 (06) 464-470
- 36 Dundar ZD, Koylu R, Ergin M, Gunaydin YK, Ozer R, Cander B. Prognostic value of red cell distribution width in patients with organophosphate poisoning. J Acad Emerg Med 2015; 14 (02) 65-69
- 37 Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today’s critically ill patients. Crit Care Med 2006; 34 (05) 1297-1310