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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Nov 17

DOI: 10.23736/S0375-9393.17.12102-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Can red blood cell distribution width predict outcome after cardiac arrest?

Vito FONTANA 1, Savino SPADARO 2, Paola VILLOIS 1, Claudia RIGHY SHINOTSUKA 1, Alberto FOGAGNOLO 2, Leda NOBILE 1, Jean-Louis VINCENT 1, Jacques CRETEUR 1, Fabio S. TACCONE 1

1 Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium; 2 Department of Morphological Surgery and Experimental Medicine, Arcispedale Sant’Anna, Università di Ferrara, Ferrara, Italy


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BACKGROUND: In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors.
METHODS: We performed a retrospective analysis of an institutional database including all unconscious adult patients admitted to the intensive care unit (ICU) after non-traumatic CA between January 2007 and January 2015. Patients who survived <24 hours were excluded. The RDW (normal values 10.9-13.4%) was obtained daily from the day of admission to day 3. Patients with a cerebral performance category (CPC) score of 3-5 at 3 months were considered to have an unfavorable neurological outcome.
RESULTS: Three hundred and ninety patients were included. The ICU mortality rate was 56% (n=220) and 64% of patients (n=251) had an unfavourable 3-month neurological outcome. The median RDW on the day of admission was 14 [13.0-15.2]% and remained stable over the observation period. Two hundred and forty-five patients (63%) had a high RDW (>13.4%) on admission. In multivariable logistic regression analysis, older age, absence of bystander cardiopulmonary resuscitation (CPR), a non-cardiac aetiology of the arrest, a non-shockable initial rhythm, high adrenaline dose during CPR and high admission RDW levels were independently associated with an unfavourable outcome at 3 months.
CONCLUSIONS: High RDW values are associated with poor neurological outcome among CA survivors.


KEY WORDS: Red blood cell distribution width - Cardiac arrest - Prognosis - Outcome

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Publication History

Article first published online: November 17, 2017
Manuscript accepted: November 14, 2017
Manuscript revised: October 10, 2017
Manuscript received: March 25, 2017

Per citare questo articolo

Fontana V, Spadaro S, Villois P, Righy Shinotsuka C, Fogagnolo A, Nobile L, et al. Can red blood cell distribution width predict outcome after cardiac arrest? Minerva Anestesiol 2017 Nov 17. DOI: 10.23736/S0375-9393.17.12102-4

Corresponding author e-mail

ftaccone@ulb.ac.be