Assessing the Prognostic Accuracy of Red Cell Distribution Width for Predicting Mortality in Sepsis Patients: A Comparative Study With Serum Lactate and the Quick Sequential Organ Failure Assessment (qSOFA) Score.

backgroundSepsis is a clinical condition characterized by high morbidity and mortality. Several prognostic markers have been evaluated to identify patients with severe sepsis. The red cell distribution width (RDW) is a cost-effective and widely accessible laboratory test to predict mortality across various medical conditions. This research aimed to evaluate the role of RDW as a predictor of mortality in sepsis patients and compare its predictive value with that of serum lactate levels and the qSOFA (quick Sequential Organ Failure Assessment) score.

methodsThis prospective observational study enrolled sepsis patients admitted to the Medicine Department at the Indira Gandhi Institute of Medical Sciences between March and August 2024. The study evaluated the discriminatory ability of RDW, serum lactate levels, and qSOFA score for predicting mortality by calculating the ROC-AUC (receiver operating characteristic area under the curve).

resultsOut of 100 eligible patients, 97 had been incorporated into the final analysis. The mean RDW was significantly elevated among the non-survivors, and it had been recognized as an independent predictor of 30-day mortality (OR=2.91, (1.56; 5.42), p < 0.001). For predicting 30-day mortality, the AUC values were as follows: RDW at 0.878 (p < 0.001), lactate at 0.719 (p < 0.001), and qSOFA score at 0.837 (p < 0.001). The cutoff value for RDW was established at 14.15%.

conclusionRDW was significantly associated with 30-day mortality in sepsis patients and was found to be an independent prognostic marker for predicting mortality. Its mortality discriminative ability was comparable to that of the qSOFA score but superior to that of lactate.