红细胞分布宽度评估脓毒症患者预后的价值

Prognostic value of red blood cell distribution width in patients with sepsis

目的探讨红细胞分布宽度(RDW)对脓毒症患者预后的评估作用。方法回顾性分析2019年1月至2022年7月南京大学医学院附属南京鼓楼医院重症监护病房(ICU)收治的252例脓毒症患者,男性167例,平均(65.50±14.81)岁;女性85例,平均(59.39±16.53)岁,所有患者接受脓毒症标准治疗。根据患者28 d存活状况将分为存活组(153例)和死亡组(99例),收集患者入院第1、2、3、7天的RDW值和其他检查检验结果;绘制受试者工作特征曲线(ROC),分析不同时间段RDW对患者预后的评估价值。结果ROC曲线下面积(AUC)表明入院第1天红细胞分布宽度(RDW D1)对28 d病死率具有较好的判断力(AUC=0.694),其判断能力与SOFA评分(AUC=0.696)、APACHⅡ评分(AUC=0.688)相当。将RDW D1加入SOFA评分时,AUC增加到0.758;当将RDW D1添加到APACHⅡ评分时,AUC增加到0.774。结论RDW是脓毒症患者死亡的独立预测标志物,RDW联合SOFA、APACHⅡ评分可提高对预后的评估能力。

Objective To investigate the effect of red blood cell distribution width(RDW)in the prognosis of patients with sepsis.Methods Patients with sepsis admitted to the intensive care unit(ICU)of Nanjing Drumsepsis admitted/Clinicaling Drumsepsis admitted to the intensive care unit ients witJuly 2022 were enrolled.All patients received standard treatment for sepsis,the RDW and other test results on the 1st,2nd,3rd and 7th days of admission were collected.The receiver operating characteristic curve(ROC)was plotted to analyze the prognostic value of RDW in different time periods on patient s’prognosis.Results A total of 252 patients with sepsis admitted to the ICU were selected,including 167 males and 85 females,aged(63.4ludin)years,153 cases survived in 28 days,and 99 died.The area under the ROC curve(AUC)showed that the width of red blood cell on the first day(RDW D1)had a good judgment on 28-day mortality(AUC=0.694),and its judgment ability was comparable to the SOFA score(AUC=0.696)and APACH Ⅱ score(AUC=0.688).When RDW D1 was added to the SOFA score,the AUC increased to 0.758;when RDW D1 was added to the APACH Ⅱ score,the AUC increased to 0.774.Conclusion RDW is an independent predictor of mortality in patients with sepsis.RDW can improve the ability to assess prognosis when combined with SOFA and APACH Ⅱ scores.