RED BLOOD CELL DISTRIBUTION WIDTH (RDW) AS A PROGNOSTIC FACTOR IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA IN DAMASCUS HOSPITAL

Rafah Jumaa*, Asmaa Alashkar and PhD. Hussam Al-Bardan

ABSTRACT

Background: Pneumonia is a common acute respiratory infection that affects the alveoli and distal airways; it is a major health problem and associated with high morbidity and short-term and long-term mortality in all age groups worldwide. Pneumonia is broadly divided into community-acquired pneumonia or hospital-acquired pneumonia.[1] Community-acquired pneumonia (CAP) is a global disease responsible for a large proportion of deaths and having significant economic cost.[2] Streptococcus Pneumoniae remains the most common cause of CAP across all severities. Mycoplasma pneumonia, Haemophilus Influenzae, and Chlamydophila Pneumoniae are associated with mild-to-moderate CAP and Staphylococcus aureus, Legionella species, and gram- negative pathogens, including Klebsiella Pneumoniae and Pseudomonas aeruginosa, are more likely to be associated with severe CAP.[3] However, Viruses can also infect the low respiratory tract and cause pneumonia. The most common viral pathogens are influenza A and B; parainfluenza 1, 2 and 3; respiratory syncytial virus; or adenovirus.[4] Red cell distribution width (RDW) is associated with mortality in patients with community-acquired pneumonia (CAP). Although The relationship between morbidity, mortality and RDW value is weak. The objective of this study was to evaluate the association between RDW changes and mortality in hospitalized patients with CAP.[5] Methods: Retrospective analyses were performed using medical records of patients hospitalized for CAP from April 2019 to June 2024 in Damascus hospital in Damascus, Syria. The abstracted values included Age, Gender, Length of stay in hospital, ICU admission, Length of stay in ICU, Need for mechanical ventilation, Mortality. RDW was measured using an automated hematology analyzer. Results: A total of 122 patients were included. The results show that there was no significant difference in the distribution of RDW values between males and females (P=0.38). Also, there was no statistically significant relationship between age and RDW values (P=0.09). Patients with higher RDW values (14-15) were more likely to need ICU admission (53.3%, P =0.011) and mechanical ventilation (46.7%, P =0.019) compared to those with low RDW values but still RDW is not a reliable predictor of ICU admission and mechanical ventilation. Length of hospitalization was significantly associated with higher levels of RDW value (P = 0.02). There was no significant difference in Length of stay in the ICU (P = 0.67) and mortality rates (P = 0.16) between the different RDW value groups. Conclusion: Higher RDW value is associated with some of the more severe clinical outcomes, such as increased ICU admission and need for mechanical ventilation, in this sample of patients with pneumonia but its not a reliable predictor.

Keywords: Red blood cells distribution width, Community-acquired pneumonia, RDW as a prognostic factor, ICU admission, Mechanical ventilation.