Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6
Abstract Red blood cell distribution width (RDW) has been reported as a meaningful prognostic factor in various diseases. Our study compared patients’ RDW levels and prognosis at admission and discharge time. A total of 128 patients 77 patients who suffered brain death (subject group), and 51 patien...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-08-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-39836-6 |
| _version_ | 1827723206015844352 |
|---|---|
| author | Marzieh Latifi Habib Rahban Elahe Pourhosein Daniel Shostak Sanaz Dehghani |
| author_facet | Marzieh Latifi Habib Rahban Elahe Pourhosein Daniel Shostak Sanaz Dehghani |
| author_sort | Marzieh Latifi |
| collection | DOAJ |
| description | Abstract Red blood cell distribution width (RDW) has been reported as a meaningful prognostic factor in various diseases. Our study compared patients’ RDW levels and prognosis at admission and discharge time. A total of 128 patients 77 patients who suffered brain death (subject group), and 51 patients who were discharged from the hospital (control group) with GCS ≤ 6 were recruited from 60 hospitals for this study. Demographical data and RDW measurements in these patients at admission time and brain death/discharge time were extracted into two groups. 46 (35.9%) patients were females and 82 patients (64.1%) were males with a median age of 36 years old. A significant difference in baseline characteristics of GCS (P < 0.001), RDW at admission time (P < 0.001), and RDW at discharge or brain death time (P < 0.001) were noted between the two groups. In the overall population, RDW at admission time had a median value of 13.75% and was positively correlated with gender (P < 0.04, rs = 0.582) and age (P < 0.023, rs = − 0.201). Initially, there were no significant differences in RDW upon admission. However, upon discharge, although the RDW in the control group was not significant (P < 0. 1), the RDW level at the time of brain death was notably 0.45 fold higher (P = 0.001) compared to the time of admission. The standardized residuals at the two-time points showed an approximately normal distribution. The most effective RDW cut-off in Brain death was determined as 14.55. Based on the findings, using RDW as a prognostic factor has a sensitivity of 0.468 and a specificity of 0.137 in diagnosing brain death. RDW biomarker is a simple and inexpensive laboratory test that may be seen as a valuable perspective for initial patient evaluation. RDW is a powerful marker for the prognosis of brain death in patients with a GCS ≤ 6 at admission time, in order to identify a subset of patients who may require more aggressive management in the trauma center. |
| first_indexed | 2024-03-10T21:56:05Z |
| format | Article |
| id | doaj.art-f6f9d375323b4124be638ed117072d29 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T21:56:05Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-f6f9d375323b4124be638ed117072d292023-11-19T13:08:54ZengNature PortfolioScientific Reports2045-23222023-08-011311610.1038/s41598-023-39836-6Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6Marzieh Latifi0Habib Rahban1Elahe Pourhosein2Daniel Shostak3Sanaz Dehghani4Medical Ethics and Law Research Center, Shaheed Beheshti University of Medical SciencesCardiovascular Research Foundation of Southern CaliforniaSina Organ Procurement Unit, Sina Hospital, Tehran University of Medical SciencesCardiovascular Research Foundation of Southern CaliforniaSina Organ Procurement Unit, Sina Hospital, Tehran University of Medical SciencesAbstract Red blood cell distribution width (RDW) has been reported as a meaningful prognostic factor in various diseases. Our study compared patients’ RDW levels and prognosis at admission and discharge time. A total of 128 patients 77 patients who suffered brain death (subject group), and 51 patients who were discharged from the hospital (control group) with GCS ≤ 6 were recruited from 60 hospitals for this study. Demographical data and RDW measurements in these patients at admission time and brain death/discharge time were extracted into two groups. 46 (35.9%) patients were females and 82 patients (64.1%) were males with a median age of 36 years old. A significant difference in baseline characteristics of GCS (P < 0.001), RDW at admission time (P < 0.001), and RDW at discharge or brain death time (P < 0.001) were noted between the two groups. In the overall population, RDW at admission time had a median value of 13.75% and was positively correlated with gender (P < 0.04, rs = 0.582) and age (P < 0.023, rs = − 0.201). Initially, there were no significant differences in RDW upon admission. However, upon discharge, although the RDW in the control group was not significant (P < 0. 1), the RDW level at the time of brain death was notably 0.45 fold higher (P = 0.001) compared to the time of admission. The standardized residuals at the two-time points showed an approximately normal distribution. The most effective RDW cut-off in Brain death was determined as 14.55. Based on the findings, using RDW as a prognostic factor has a sensitivity of 0.468 and a specificity of 0.137 in diagnosing brain death. RDW biomarker is a simple and inexpensive laboratory test that may be seen as a valuable perspective for initial patient evaluation. RDW is a powerful marker for the prognosis of brain death in patients with a GCS ≤ 6 at admission time, in order to identify a subset of patients who may require more aggressive management in the trauma center.https://doi.org/10.1038/s41598-023-39836-6 |
| spellingShingle | Marzieh Latifi Habib Rahban Elahe Pourhosein Daniel Shostak Sanaz Dehghani Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 Scientific Reports |
| title | Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 |
| title_full | Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 |
| title_fullStr | Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 |
| title_full_unstemmed | Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 |
| title_short | Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6 |
| title_sort | association between red blood cell distribution width and the prognosis of brain death in patients with a glasgow coma scale 6 |
| url | https://doi.org/10.1038/s41598-023-39836-6 |
| work_keys_str_mv | AT marziehlatifi associationbetweenredbloodcelldistributionwidthandtheprognosisofbraindeathinpatientswithaglasgowcomascale6 AT habibrahban associationbetweenredbloodcelldistributionwidthandtheprognosisofbraindeathinpatientswithaglasgowcomascale6 AT elahepourhosein associationbetweenredbloodcelldistributionwidthandtheprognosisofbraindeathinpatientswithaglasgowcomascale6 AT danielshostak associationbetweenredbloodcelldistributionwidthandtheprognosisofbraindeathinpatientswithaglasgowcomascale6 AT sanazdehghani associationbetweenredbloodcelldistributionwidthandtheprognosisofbraindeathinpatientswithaglasgowcomascale6 |