Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit

Ayush Dubey; Sunil Kumar; Sourya Acharya; Anil K Wanjari; Shilpa Bawankule; Sachin Agrawal; Ashlesha Shukla

doi:10.1055/s-0041-1730883

Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit

J Lab Physicians. 2021 Jun 26;13(4):309-316. doi: 10.1055/s-0041-1730883. eCollection 2021 Dec.

Authors

Ayush Dubey¹, Sunil Kumar¹, Sourya Acharya¹, Anil K Wanjari¹, Shilpa Bawankule¹, Sachin Agrawal¹, Ashlesha Shukla²

Affiliations

¹ Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India.
² Department of Medicine, Institute of Medical Sciences and SUM Hospital (deemed to be university), Bhubaneswar, Odisha, India.

Abstract

Introduction The red blood cell distribution width (RDW) is a measurement of variations in the size of red blood cells. As the width increases, the rate of mortality also increases, although the reason for it is still not known. On the other hand, platelet distribution width (PDW) is also useful in predicting morbidity and mortality in sepsis and other critically ill patients. In our study, we planned to study the impact of both RDW and PDW and evaluate their prognostic importance with outcome in patients admitted in medicine intensive care unit (MICU). Material and Method In these cross-sectional observational studies, 1,300 patients were included who were admitted in MICU. Critically ill patients were defined on the basis of qSOFA score greater than 2. PDW and RDW were obtained from Coulter report of complete blood count. Parameters included in Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were taken and APACHE IV score was calculated. Correlation of RDW and PDW with outcomes such as length of ICU stay, use of mechanical ventilator, and discharge/death was done. Result The mean RDW (%) for the entire study population was 15.17 ± 3.01. The RDW (%) was significantly on the higher side in patients who succumbed to the disease as compared with the patients who were discharged. The correlation between the length of ICU stay (days) and RDW (%) was moderately positive and was significant (rho = 0.37, p ≤ 0.001). The correlation between the length of ICU stay (days) and PDW (%) was moderately positive and was significant (rho = 0.5, p ≤ 0.001). Conclusion RDW and PDW were found as significant indicators for period of stay in ICU, requirement for mechanical ventilation, and mortality rate in patients admitted to ICUs. As these are simple, easy to conduct, universally available tests, they can be regularly incorporated in patients admitted in ICUs.

Keywords: critically ill; morbidity; mortality; platelet distribution width; red cell distribution width.

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