Nghiên cứu sự biến đổi của độ phân bố hồng cầu và giá trị tiên lượng tử vong ở bệnh nhân sốc nhiễm khuẩn

Abstract

Objective: To assess the variation of red cell distribution width (RDW) in septic shock patients and its association with mortality prognosis in septic shock patients. Subject and method: A prospective longitudinal descriptive study, with 97 patients at the Intensive Care Unit of 108 Military Central Hospital from April 2023 to January 2024. Patients ≥ 18 years old, diagnosed with septic shock according to SCCM/ESICM 2016 criteria. RDW index measured at the time of septic shock diagnosis, on days 1, 3, 5, 7 after septic shock diagnosis. Assess the variation of RDW and prognostic value of RDW for mortality to compare with SOFA and APACHE II scores in septic shock patients. Result: The average RDW index in the deceased patient group was higher than in the surviving patient group (p<0.01). RDW index at T7 (AUC = 0.9, p<0.001) with a cutoff of 17% had a higher value than both SOFA and APACHE II scores in predicting mortality with a sensitivity of 80% and specificity of 89.5%. RDW in the deceased patient group was higher than in the surviving patient group from T0 to T7 (p<0.01). In the deceased patient group, this index notably increased at T5 (16.8%) and T7 (18.7%). In the surviving patient group, RDW showed less variation during the study periods with average values ranging from 14.4 ± 1.4% to 15.1 ± 1.78% (p<0.05). Conclusion: The RDW index at various study time points with cutoffs of 14.9-17%, as well as the gradually increasing variability of this index, have significant value in predicting mortality in patients with septic shock compared to the SOFA and APACHE II scores (p<0.05).