Role of red cell distribution width in assessing response to treatment and prognosis in community‑acquired pneumonia: A prospective study

Abstract

BACKGROUND AND AIM: Red blood cell distribution width (RDW) elevation occurs in variousinflammatory/infectious conditions. RDW levels during monitoring have not been investigatedprospectively in community‑acquired pneumonia (CAP). In CAP, the relationship betweenantibiotherapy response and RDW levels is unclear.MATERIALS AND METHODS: This prospective cohort study included a total of 65 CAP patients.Total complete blood cell (including RDW) count, blood biochemistry analysis, and arterial blood gastests were performed on admission. RDW was also performed on the 7th day.RESULTS: Total mean RDW level was 16.2% ± 1.9% in the study population. The level was17.7% ± 2.1% in nonsurviving CAP patients and 15.9% ± 1.8% in surviving CAP patients (P = 0.01).Pretreatment RDW levels were 16.2% ± 1.9% as compared to 15.3% ± 2.2% on the 7th day (P = 0.002).An RDW cutoff >16.5% predicted 30‑day mortality with 78% sensitivity and 70% specificity. The riskof 30‑day mortality was 9‑fold higher in patients with elevated RDW as assessed by multivariatelogistic regression analysis for CAP.CONCLUSION: RDW can be used as an important parameter in assessing response to antibiotherapy.We also speculate that high RDW is a poor prognostic marker for CAP.