RDW as a Prognostic Marker of Sepsis and its Comparison with APACHE II Score: A Prospective Observational Cross-sectional Study

Introduction: Sepsis is one of the most important and common cause for Intensive Care Unit (ICU) admission. Life-threatening organ dysfunction is caused by a dysregulated host response to infection. Clinical scoring system is cumbersome for prognosticating sepsis outcome. Red cell Distribution Width (RDW) is a part of routine investigation done in the form of Complete Blood Count (CBC), inexpensive and easily available.

Aim: To evaluate RDW as a prognostic marker of sepsis and its comparison with APACHE II (Acute Physiology and Chronic Health Evaluation II) score.

Materials and Methods: The present study was a prospective observational cross-sectional study was conducted at MLN Medical College and associated Swaroop Rani Nehru Hospital, Prayagraj, Uttar Pradesh, India, which included 110 patients diagnosed with sepsis. The patients were divided into survivors and non survivors group. CBC, liver function test, kidney function test, serum electrolytes, Arterial Blood Gas (ABG) analysis, blood culture, site-specific culture were done and APACHE II was calculated.

Results: Out of the 110 patients enrolled in the study, 61 were males and 49 were females. Mean±SD age of the non survivors (n=42) was 57.45±22.93 years and that of survivors (n=68) was 58.59±17.18 years. APACHE II score in the non survivors was 18.50±6.80 while that among the survivors was 10.51±6.61 (p<0.001). RDW in the non survivors was 17.62±4.29 while that in the survivors was 13.99±1.66 (p<0.001).

Conclusion: The RDW was found to be significantly higher in non survivor group as compared to survivor in this study. So RDW at admission can be used as simple, easy to perform prognostic marker of sepsis.