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Red cell distribution width as a predictor of late‐onset Gram‐negative sepsis
Author(s) -
Dogan Pelin,
Guney Varal Ipek
Publication year - 2020
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14123
Subject(s) - medicine , red blood cell distribution width , sepsis , odds ratio , confidence interval , logistic regression , cohort , neonatal sepsis , cohort study , intensive care unit , neonatal intensive care unit , pediatrics , gastroenterology
Abstract Background Late‐onset sepsis (LOS) remains an important cause of morbidity and mortality in preterm infants. In this study, our aim was to investigate the red‐cell distribution width (RDW) levels during a LOS episode, and its association with the type of growing microorganism and mortality. Methods Preterm infants with culture‐proven sepsis during their neonatal intensive care unit stay were enrolled. Red‐cell distribution width levels were obtained in the first 4 h of postnatal life and at the onset of the LOS episode, and compared for these time frames. The study cohort was divided into two groups according to the type of the growing microorganism. The RDW levels were then assessed in intra‐ and inter‐group analyses. Results Eighty‐six infants were included in the final analysis. RDW levels were increased in the study cohort after a LOS attack ( P < 0.001). Infants with Gram‐negative sepsis showed a significant increase in their RDW levels, but they remained unchanged in infants with Gram‐positive sepsis ( P < 0.001 and P = 0.4, respectively). An RDW cut‐off of >19.50% was related with a sensitivity of 87% and a specificity of 81% for predicting late‐onset Gram‐negative sepsis ( P < 0.001). Logistic regression analysis showed a positive association of RDW with mortality when adjusted for covariants (adjusted odds ratio: 1.40; 95% confidence interval: 1.02–1.80; P = 0.03). Conclusions Our findings show that RDW levels increased during a LOS episode in preterm infants, which was especially evident in Gram‐negative infections. We believe that these findings may be of importance in the early diagnosis and prognosis of LOS in preterm infants.