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KMID : 0385920140250060667
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Journal of the Korean Society of Emergency Medicine
2014 Volume.25 No. 6 p.667 ~ p.675
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Red Cell Distribution width in Older Patients with Community-acquired Pneumonia in the Emergency Department
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Yeon Jeong-Hoon
Kim Soo-Hyun
Youn Chun-Song
Park Kyu-Nam
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Abstract
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Purpose: Red cell distribution width (RDW) is a quantitativemeasure of variability in the size of circulating erythrocytes. Recent studies have shown that higher RDW is associatedwith increased mortality risk in patients with several diseases. In particular, community-acquired pneumonia (CAP)is a prevalent and potentially life-threatening infection andhas poor prognosis in older patients. We investigated theassociation of RDW in older patients with CAP.
Methods: We conducted a retrospective analysis studyduring the period from May, 2013 to October, 2013. Patients older than 65 who were treated with CAP in ouremergency department were included in this study. Wedivided the two groups by RDW 14.5%, the best cutoffvalue for mortality by receiver operating curve (ROC) analysis. The primary outcome was in-hospital mortality. APACHE II, SOFA, PSI Class, and CURB 65 were calculated. Multivariate logistic regression analysis was performedto determine the risk factors for mortality.
Results: A total of 569 patients were analyzed and overallmortality was 10.2%. Mean age was 76.7 years and rangeof RDW was 10.5%~26.2%. There were 208 patientsabove 14.5%. Significant differences in in-hospital mortalitywere observed between the two groups (15.0% vs. 22.1%,respectively). In multivariate logistic regression analysis,RDW>14.5% showed an association with mortality(OR=2.08, 95% CI 1.03-4.19). In ROC analysis, area underthe curve of RDW was 0.716 (95%CI, 0.677-0.753).
Conclusion: RDW at admission is associated with in-hospitalmortality in older patients with CAP; and it might be aprognostic marker for mortality of CAP in older patients inthe emergency department.
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KEYWORD
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Red cell distribution width, Pneumonia, Mortality, Elderly
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