Red cell distribution width as a prognostic marker in severe sepsis and septic shock

Mohammed Aslam Shaikh, Durga Rao Yadavalli


Background: The incidence of severe sepsis and septic shock has increased over the past 30 years, and the annual number of cases is now >700,000 (~3 per 1000 population). There are many markers of sepsis which are being evaluated for its diagnosis among which RDW is emerging as a promising marker. Hence this study is being done to see the correlation between RDW and sepsis.

Methods: A total of 162 patients-81 survivors and 81 non-survivors of severe sepsis and septic shock fulfilling inclusion and exclusion criteria who were admitted to intensive care unit between October 2013 and September 2015 were included in the study. Baseline variables, laboratory parameters, complications, and RDW were compared between the two groups.

Results: Majority of patients - 73(45.06%) were in the age group of 61 - 80 years. Mean RDW was 15.20±2.29 in non-survivors and 13.86±2.20 in survivors, which was statistically significant (p<0.001). Mean RDW was higher and statistically significant among non-survivors with respect to duration of stay and requirement of inotropes.

Conclusions: RDW levels measured on admission can be used as a prognostic marker in patients in severe sepsis and septic shock.


Red cell distribution width, Sepsis, Septic shock

Full Text:



Hotchkiss RS, Karl IE. The Pathophysiology and treatment of sepsis. N Engl J Med 2003. Jan 9;348(2):138-50.

Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med. 1991;9 Suppl 1:71-4.

Mahmood NA, Mathew J, Kang B, DeBari VA, Khan MA. Broadening of the red blood cell distribution width is associated with increased severity of illness in patients with sepsis. Int J Crit Illn Inj Sci. 2014;4(4):278-82.

Shaikh MAS, Durga Rao YJN. Comparison of red cell distribution width with SOFA score as a prognostic marker of sepsis in elderly patients. JEMDS. 2015;4(99):16434-8.

Shaikh MAS, Akhila AV. Red cell distribution width as prognostic marker in organophosphorous compound poisoning. IOSR-JDMS. 2015;14(9):21-4.

Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive care medicine. 2008;34(1):17-60.

Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, Kang KW, Kim J, Rhee JE. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med. 2013;31(3):545-8.

Lorente L, Martín MM, Abreu-González P, Solé-Violán J, Ferreres J, Labarta L, et al. Red blood cell distribution width during the first week is associated with severity and mortality in septic patients. PloS one. 2014;9(8):e105436.

Mori KI, Noguchi M, Sumino Y, Sato F, Mimata H. Use of procalcitonin in patients on chronic hemodialysis: procalcitonin is not related with increased serum calcitonin. ISRN urology. 2012;2012.431859.

Herget‐Rosenthal S, Marggraf G, Pietruck F, Hüsing J, Strupat M, Philipp T, Kribben A. Procalcitonin for accurate detection of infection in haemodialysis. Nephro Dial Transplant. 2001;16(5):975-9.

Quiroga B, Villaverde M, Vega A, Abad S, Reque J, López-Gómez JM. Procalcitonin as an early predictor of acute infection in hemodialysis patients. Nefrologia. 2014;34(3):341-6.

Esper RC, Domínguez VC, Córdova LD. Red blood cell distribution width changes in septic patients. Medicina Critica y Terapia Intensiva. 2008;22:20-5.

Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.