Publication: Using red cell distribution width (RDW) to improve prognostic performance of crb 65 and to compare its accuracy with curb 65 in predicting 30 - day mortality in adult patients hospitalized for community acquired pneumonia (CAP) from emergency department of Hospital Universiti Sains Malaysia (USM): A retrospective observational study
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Date
2022
Authors
Rajoe, Helena Sharmini A
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Abstract
Introduction: Red cell distribution width (RDW) and mortality are vastly studied in various diseases. However, the connection between RDW and mortality in community-acquired pneumonia (CAP) remains unknown. We aim to use RDW to improve the prognostication of CRB 65 and to compare its accuracy with CURB 65 in forecasting 30-day mortality among CAP patients. Methodology : A retrospective cohort analysis of patients hospitalized for CAP is carried out. The CRB 65 and CURB 65 were calculated for each patient. A third score was calculated by adding RDW into CRB 65. The primary outcome is to identify the 30-day mortality. Prognostic accuracy was evaluated after the addition of RDW into CRB 65 scoring. In addition, several indicators such as sensitivity, specificity, positive predictive value and negative predictive value, area under the receiver operating characteristic (ROC) curve with 95% CI were calculated for each scoring system and compared. Results: Patients with higher RDW showed higher 30 day mortality, ICU admissions, vasopressor, and mechanical ventilation requirements. CURB-65 scoring system had the highest AUC (81.8%), followed by CRB 65 + RDW (77.9%) and CRB 65 (74.3%) in forecasting 30-days mortality among CAP patients. When comparing the ROC between the three scoring systems, CURB 65 had a significant difference with CRB 65, but no significant difference with CRB 65 + RDW. Conclusion: In conclusion, modification of CRB 65 by including RDW improved the prognostic performance of CRB 65. Future studies are needed from patients with different socio-demographic backgrounds to explore and evaluate the role of RDW as a prognostic marker in CAP patients
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Keywords
Community Acquired Pneumonia , Red cell Distribution Width