Efficacy of Red Cell Distribution Width as a Predictor of High Risk and Early Mortality in Upper Gastro-intestinal Bleeding: A Pilot Clinical Study.
- Author:
Sin Young KIM
1
;
Jin Yong KIM
;
Jung Hoon LEE
;
Kyeong Ryong LEE
;
Dae Young HONG
;
Kwang Je BAEK
;
Sang O PARK
Author Information
1. Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Hospital, Seoul, Korea. empso@kuh.ac.kr
- Publication Type:Original Article
- Keywords:
Erythrocyte indices;
Gastrointestinal hemorrhage
- MeSH:
Area Under Curve;
Early Intervention (Education);
Electronic Health Records;
Emergency Service, Hospital;
Erythrocyte Indices*;
Gastrointestinal Hemorrhage;
Hemorrhage*;
Humans;
Mortality*;
Retrospective Studies;
Sensitivity and Specificity
- From:Journal of the Korean Society of Emergency Medicine
2015;26(6):517-525
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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). METHODS: 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.
