To Investigate The Predictive Value Of Red Cell Distribution Width In The Aged Patients With Community Acquired Pneumonia

Objective To investigate the predictive value of red cell distribution width(RDW)in the aged patients with community acquired pneumonia(CAP).Methods 205 elderly patients with CAP from the emergency medical ward and emergency intensive care unit of the first affiliated hospital of ANHUI medical university were retrospectively analyzed.According to RDW on admission,the patients were divided into four groups(RDW<13.1、13.1≤RDW<13.8、13.8≤RDW<14.9、RDW≥14.9),CURB-65 scores,30-day mortality outcomes,intensive care unit occupancy,organ failure and the duration of hospital stay were detected.According to CURB-65 scores,Total elderly patients with CAP were divided into low risk group(n=146,<3)and high risk group(n=59,≥3).Their white blood cell(WBC),procalcitonin(PCT),C-reactive protein(CRP),Red cell distribution width(RDW)were measured after admission,the duration of hospital stay was counted,Data between the two groups were compared.RDW and CURB-65 scores and the test index which predicted mortality in elderly hospitalized patients with CAP were statistical analyzed.Results:1.Among four groups of RDW,CURB-65 scores 30-day mortality incidence of organ failure and intensive care unit occupancy rate was statistically difference(P < 0.05),and with increasing RDW,higher CURB-65 scores≥3,higher incidence of organ failure and intensive care unit occupancy percentage;The duration of hospital stay was no statistical significance between groups(P = 0.601).2.Between the two groups of CURB-65 scores,RDW,PCT,CRP,the duration of hospital stay and WBC is difference between high risk group and low risk group.RDW,PCT and CRP was statistically significant(P = 0.004;P = 0.004;P < 0.01),The duration of hospital stay exist statistical difference(P = 0.012),The WBC differences between the two groups has no statistical significance(P = 0.209).3.Prediction of death in elderly patients with CAP.ROC curve was drawn to evaluate role of WBC,RDW,PCT,CRP and CURB-65 scores in elderly CAP death,There are statistical significance of the indicators for the RDW,PCT,CRP and CURB-65scores(P < 0.01),the data by the ROC analysis found that when RDW is 14.75,To predict the sensitivity of the death is 0.625,specificity is 0.812,the area under the curve(AUC)is 0.75;When PCT is 0.189,To predict the sensitivity of the death is 0.800,the specificity is 0.509,the area under the curve(AUC)is 0.688;When CRP is 75.88,To predict the sensitivity of the death is 0.725,the specificity is 0.642,the area under the curve(AUC)is 0.698;When CURB-65 is 2.5,To predict the sensitivity of the death is0.725,the specificity is 0.818,the area under the curve(AUC)is 0.836;And WBC as a predictor is not statistically significant(P = 0.88).4.30-day mortality in elderly patients with CAP and RDW、PCT、CRP、WBC were analyzed.The results show that correlation coefficient with RDW is 0.243(P < 0.01);Correlation coefficient with PCT is 0.026(P = 0.674);Correlation coefficient with CRP is 0.152(P = 0.014);Correlation coefficient with CURB-65 score is 0.407(P <0.01);Correlation coefficient with the WBC is-0.067(P = 0.246);RDW、CURB-65 score has statistical significance(P < 0.01),CRP has statistical significance(P < 0.05),the PCT and the WBC has no statistical significance(P ≧ 0.05).Conclusion RDW can be used for clinical evaluation of the severity of disease in elderly patients with CAP;Both of RDW and CURB-65 scores can be used to predict prognosis of death.