Background:Inflammatory and oxidative stress caused by infection has recently been proposed as a mechanism of association between the red cell distribution width (RDW) and infectious diseases, such as community-acquired pneumonia(CAP).
Objective:The present goal was to assess the prognostic importance of the RDW test in patients with CAP.
Patients and methods: The present research was a descriptive and prospective study of patients diagnosed with CAP. All were admitted to Chest Department of Assiut University Hospital between April 2017 and July 2018.Assessment of CAP severity at time of hospital admission using Pneumonia Severity Index was done for all enrolled patients. Complete blood count was measured by automated hematology analyzer, and RDW was reported as a part of the complete blood count result. Normal reference range of RDW was 11.5–14.5%. All of the patients were followed up until being discharged. The outcome variable was in-hospital mortality.
Results:The current study involved 94 patients with CAP: 77(82%) survived and 17 (18%) died. RDW level was significantly higher in non survivors compared with survivors(18.52±3.07 vs. 12.76±2.08;P=0.022). A significant positive relationship was found between RDW level and Pneumonia Severity Index points (r=0.664;P=0.000). Regarding the diagnostic performance of the RDW test, it was observed that RDW level at cutoff point more than 16.1% had 94.12%sensitivity and 98.70% specificity for the prediction of in-hospital mortality in patients with CAP.
Conclusion: The present data indicated that the measurement of RDW on admission may provide the physician with a tool to predict the outcomes of patients with CAP and thus assist in decision making and management in such cases either alone or alongside the other well-established means, taking into account that RDW testing is simple, cheaper, and readily available.