Association between Red Cell Distribution Width and Mortality in Pediatric Patients Admitted to Intensive Care Units

Background: Red cell distribution width (RDW) is a routine laboratory measure that could be used as a predictor of mortality in critically ill patients. Identification of patients at risk for mortality early in the course of PICU admission is an important step in improving the outcome. We aimed to assess the use of RDW as an early biomarker for outcome in pediatric critical illnesses. Methods: A retrospective study by extracting administrative and laboratory data from patients admitted to PICU of an academic pediatric teaching hospital was accomplished. After exclusion of 64 patients according to our exclusion criteria, 304 pediatric patients with PICU admissions over the 6 months of study period were included in the study. Results: The mean RDW for all patients was 14.9%±2.5%. PICU mortality was 13.3%. The rate of mortality in the quartile of RDW>15.7% was 20.1%. Elevated RDW was associated with longer duration of PICU admission (P<0.001). Tracheal intubation and ventilator support was needed in 34.2% of the patients. This was also correlated with elevated RDW (P=0.043). Conclusion: We observed that higher RDW was strongly linked to higher mortality risk in pediatric patients admitted in PICU. Higher RDW was associated with longer duration of PICU admission.