Prognostic Value of the Red Cell Distribution Width in Patients with Sepsis-Induced Acute Respiratory Distress Syndrome: A Retrospective Cohort Study

OBJECTIVE: The prognostic value of the red cell distribution width (RDW) in patients with sepsis-induced acute respiratory distress syndrome (ARDS) is still elusive. This study is aimed at determining whether RDW is a prognostic indicator of sepsis-induced ARDS. METHODS: This retrospective cohort study included 1161 patients with sepsis-induced ARDS. The datasets were acquired from the Medical Information Mart for Intensive Care III database. The locally weighted scatter-plot smoothing technique, Cox regression, Kaplan-Meier estimator, and subgroup analysis were carried out to evaluate the association between RDW and 90-day mortality. RESULTS: The RDW and mortality had a roughly linear increasing relationship. The Cox regression model results were as follows: for level 2 (14.5% < RDW < 16.2%), hazard ratio (HR) = 1.35, 95% confidence interval (CI) = 1.03–1.77, and for level 3 (RDW ≥ 16.2%), HR = 2.07, 95% CI = 1.59–2.69. The following results were obtained when RDW was treated as a continuous variable: HR = 1.11, 95%CI = 1.06–1.15. The P values of the interaction between the RDW and covariates were greater than 0.05. CONCLUSION: RDW is a new independent prognostic marker for patients with sepsis-induced ARDS.