Predictive factors for sepsis diagnosis, length of intensive care unit (ICU) stay and mortality in ICU

Background: The incidence of sepsis is worldwide. We aimed to assess the value of enhanced red cell distribution width (RDW) to predict sepsis and evaluate factors affecting length of intensive care units (ICU) stay and in-hospital mortality among sepsis patients.Materials and Methods: In a prospective study, we had 187 patients, which after exclusion of 27 patients, we included 160 adult patients with suspicious sepsis admitted in the university affiliated Hospital with 33 ICU-beds from 2010 to 2012. Nighty patients were diagnosed with sepsis and the source of infection was defined. Receiver–operating characteristic (ROC) curves were used to examine the sepsis predictions from RDW, APACHE II scores, and combination of them. The primary endpoint of this analysis was ICU mortality. The secondary endpoints were length of stay in ICU and hospital. A linear regression analysis was used to study risk factors for longer ICU stay and we used Logistic regression analysis to predict factors affecting in-hospital mortality.Results: The addition of elevated RDW value to acute physiology and chronic health evaluation (APACHE) II score in critically illness states enhanced the AUC for predicting sepsis and its differentiation from SIRS. Female patients and those with numerous co-morbidities or AKI and those on mechanical ventilation significantly stayed longer in ICU. Moreover, the patients with higher APACHE II score died significantly more than others.Conclusion: The addition of elevated RDW value to APACHEII score in critically illness helps to differentiate sepsis from SIRS.

Keywords:

Red blood cells distribution width , Intensive Care Unit , Factor