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KMID : 0385920150260060517
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Journal of the Korean Society of Emergency Medicine
2015 Volume.26 No. 6 p.517 ~ p.525
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Efficacy of Red Cell Distribution Width as a Predictor of High Risk and Early Mortality in Upper Gastro-intestinal Bleeding: A Pilot Clinical Study
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Kim Sin-Young
Kim Jin-Yong
Lee Jung-Hun
Lee Kyeong-Ryong
Hong Dae-Young
Baek Kwang-Je
Park Sang-O
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Abstract
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Purpose: The aim of the study is to evaluate the efficacy of initial red cell distribution width (RDW) levels in the emergency department (ED) in predicting early 28-day mortality and high risk patients for early intervention in patients with upper gastrointestinal hemorrhage (UGIB).
Method: This is a retrospective clinical study including UGIB patients in the ED. All data were collected through electronic medical records. The two major endpoints were early 28-day mortality and high risk patients. We assessed the relationship between initial RDW level and high risk patients and 28-day mortality.
Results: A total of 198 patients were analyzed. There were 160 high risk patients (81.8%) and 12 non-survival patients (6.1%). The mean RDW value in high risk patients was higher than in non-risk patients (15.4±2.8 vs. 13.6±1.8%; p<0.0001). Area under curve (AUC) in Receiver-operatory characteristic (ROC) curve for RDW in high risk patients was 0.735 (95% Confidence Interval: 0.649-0.821; p<0.001) with an optimal cutoff value of 13.45% with sensitivity of 69.4% and specificity of 73.7%. The mean value of RDW in non-survivals was higher than in survivals (18.0±3.3 vs. 14.9±2.6 %; p<0.0001). AUC for RDW in predicting 28-day mortality was 0.793 (95% CI: 0.684-0.902; p<0.001) with an optimal cutoff value of 15.95% with sensitivity of 83.3% and specificity of 71.5%.
Conclusion: RDW level in initial state might be helpful in predicting high risk patients for early intervention and 28-day mortality in UGIB in the ED.
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KEYWORD
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Erythrocyte indices, Gastrointestinal hemorrhage
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