Abstract:
Objective To investigate the correlation between red cell volume distribution width (RDW) and the mortality rate of acute respiratory distress syndrome (ARDS) patients after renal transplantation.
Methods Clinical data of 106 ARDS patients undergoing renal transplantation were retrospectively analyzed. According to RDW, all patients were assigned into the normal (≤15.0%, n=68) and increasing RDW groups ( > 15.0%, n=38). Baseline data and the incidence of adverse events were statistically compared between two groups. Kaplan-Meier survival curve was adopted to compare the 50 d-mortality rate between two groups. Cox's proportional hazards regression model was utilized to identify the risk factors of the mortality of ARDS patients.
Results Among 106 patients, the 50 d-mortality rate was calculated as 43.4% (46/106). The sequential organ failure assessment (SOFA) score, serum creatinine, hemoglobin and platelet count significantly differed between two groups (all P < 0.05). In the increasing RDW group, the 50 d-mortality rate and the incidence of infectious shock were significantly higher than those in the normal RDW group (both P < 0.05). Kaplan-Meier survival curve demonstrated that the 50 d-mortality rate significantly differed between two groups (P < 0.01). Cox's proportional hazards regression model univariate analysis revealed that hemoglobin level < 100 g/L, serum creatinine > 133 μmol/L, platelet count < 100×109/L, severe ARDS and RDW > 15.0% were the potential risk factors of the 50 d-mortality rate in ARDS patients (all P < 0.05). Multivariate analysis demonstrated that severe ARDS odd ratio (OR)=12.77, 95% confidence interval (CI) 11.63-15.39, P < 0.001 and RDW > 15.0% (OR=2.01, 95%CI 1.02-3.94, P < 0.043) were the independent risk factors of the 50 d-mortality rate in ARDS patients.
Conclusions RDW elevation is correlated with the severity of disease and 50 d-mortality rate in ARDS patients following renal transplantation. RDW can serve as a clinical parameter to predict the prognosis of ARDS patients after renal transplantation.