Acute cardiac care & resuscitation
Relationship Between Initial Red Cell Distribution Width and ΔRDW and Mortality in Cardiac Arrest Patients
Authors' conclusion
Elevated RDW levels on ICU admission and rising RDW during ICU hospitalization are powerful predictors of all-cause mortality for CA patients at 30 and 360 days, and they can be used as potential clinical biomarkers to predict the bad prognosis of these patients.
Study context
- Population
- Adult cardiac arrest patients (>18 years) on first intensive care unit (ICU) admission with RDW data
- Participants
- 1,278 patients
- Exposure
- High RDW vs normal RDW at ICU admission
- Outcome
- All-cause mortality
- Follow-up
- 30 and 360 days
Methodological detailsMIMIC-IV v2.0 database, development (75%) and validation (25%) cohorts
- MIMIC-IV v2.0 database
- Development (75%) and validation (25%) cohorts
Main finding
As reported in the abstract
High RDW vs Normal RDWHazard ratio (95% CI)P value
30-day; multivariate Cox
1.451(1.181–1.782)
P < 0.001360-day; multivariate Cox
1.393(1.160–1.671)
P < 0.001- Higher cumulative survival at 30 and 360 days with normal RDW (log-rank χ2 = 36.710, χ2 = 54.960)
- both P values <0.05
Observational data: associations, not effects.
Further findings
Nomogram (anion gap, first-day SOFA, cerebrovascular disease, malignant tumour, norepinephrine use, RDW), validation cohort
- Consistency index, 30-day mortality
- 0.721
- Consistency index, 360-day mortality
- 0.725
- Well calibrated in validation cohort
RDW at ICU admission and mortality (restricted cubic spine (RCS))
- Non-linear relationship
Original publication
Relationship Between Initial Red Cell Distribution Width and ΔRDW and Mortality in Cardiac Arrest Patients. ESC Heart Fail. Published 29 November 2023. doi:10.
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