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Medicina & Laboratorio

2021, Number 3

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Medicina & Laboratorio 2021; 25 (3)

Red cell distribution width as a marker associated with mortality risk in children in intensive care

Rocha-Arrieta MC, De la Hoz-Bequis F, Guzmán-Corena Á, Muñoz-Mejía C, Castro-Dager Á

Language: Spanish
References: 53
Page: 633-647
PDF size: 107.43 Kb.


ABSTRACT

Introduction. Red cell distribution width (RDW) has recently emerged as a prognostic biomarker for mortality and other outcomes in critically ill adult patients, but there are few reports in children. The aim of this study was to evaluate the association between RDW and the risk of mortality in children admitted to a pediatric intensive care unit (PICU). Methodology. Prospective cohort study with 266 patients who met the inclusion criteria between January and September 2018. For the statistical analysis, multivariate logistic regression was used to evaluate the association of RDW on the first day and mortality. The areas under the ROC curve for ADE and the Pediatric Mortality Index 2 (PIM2) were compared. Results. A RDW at admission greater than 16.4% increased the probability of death, with an OR of 2.6 (95%CI 1.17-5.9; p=0.019). The ability of ADE to discriminate mortality was moderate (ROC 0.68; 95%CI 0.59-0.76), lower than that of the PIM2 (ROC 0.8; 95%CI 0.73-0.86). ADE and PIM2 were significantly correlated, albeit weakly (r=0.186; p‹0.002). The correlation between RDW and mechanical ventilation-free days was weak but significant (r=-0.23; p‹0.001). The RDW was not related to the days of use of vasoactive drugs (r=0.042; p=0.63) or to the days of stay in the PICU (r=0.11; p=0.07). Conclusion. RDW on admission was associated with a moderate risk of mortality during the stay in the PICU. Although it did not prove to be better than PIM2 in predicting mortality, as it is an affordable and low-cost biomarker, it could be used in conjunction with PIM2 or with other biomarkers, in order to increase its predictive ability for mortality in critically ill children. More studies are required to evaluate this possibility in our setting.


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