Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis: An Observational Prospective Cohort Study

Authors

• Ahmed Taha Gad, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, EgyptFollow
• Ghada Fathy EL-Rahmawy, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
• Naglaa Abd El-Latif El-Negeery, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
• Eiad Ahmed Ramzy, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Corresponding Author

Ahmed Taha Gad

Subject Area

Anaesthesia and Surgical Intensive Care

Article Type

Original Study

Abstract

Background: Red blood cell distribution width (RDW) is a straightforward and cost-effective parameter that is utilized in laboratory hematology to differentiate anemias. It is indicative of the grade of heterogeneity in erythrocyte volume. This study purpose examine the correlation among the risk of adverse results in patients with sepsis and RDW, as well as to equivalence the mortality discriminative capacity of RDW and lactate levels.

Methods: This observational prospective cohort study was done on 67 sepstic patients aged ≥ 21 years old, both sexes. Patients were owed into two groups according to RDW levels: Group A (n=35): normal RDW ≤ 14.5 percent, and group B (n=32):  high RDW > 14.5 percent. All patients underwent a comprehensive clinical assessment, full medical history special attention to comorbidities, vital signs, laboratory investigations (complete blood count with RDW measured at admission and at 24, 48, 72 hours, and 7 days thereafter, serum creatinine for renal function, liver enzymes (SGPT, SGOT), and platelet count).

Results: RDW can significantly predict the in-hospital mortality (area below the curve (AUC)= 0.888, P value14.6 percent, 73.33% sensitivity, 61.54% specificity, 35.5% positive predictive value (PPV) and 88.9 percent negative predictive value (NPV). Lactate can significantly predict the in-hospital mortality (AUC= 0.822, P value3.1 mmol/L, 80% sensitivity, 67.31% specificity, 41.4% PPV and 92.1% NPV.

Conclusions: Elevated RDW (>14.5%) in ICU septic patients was related to higher creatinine, increased qSOFA scores, and larger rates of intubation, septic shock, acute kidney injury, and thirty-day mortality. Both RDW and lactate predicted mortality, with RDW showing a slightly higher AUC (0.888 vs. 0.822), suggesting that RDW may represent a potentially useful and cost-effective prognostic biomarker in sepsis that warrants further validation in larger studies

Recommended Citation

Gad, Ahmed Taha; EL-Rahmawy, Ghada Fathy; El-Negeery, Naglaa Abd El-Latif; and Ramzy, Eiad Ahmed (2026) "Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis: An Observational Prospective Cohort Study," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 2.
Available at: https://doi.org/10.58775/2735-3990.1576

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