Evaluation of Red Cell Distribution Width (RDW) as an Early Marker of Sepsis in Emergency Patients
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Abstract
Background: Sepsis is a time-sensitive emergency condition in which delayed recognition may lead to organ dysfunction, shock, and death. Red Cell Distribution Width (RDW), a routinely available complete blood count parameter, may provide a low-cost supportive marker for early sepsis assessment, particularly in resource-limited emergency settings. Objective: To evaluate admission RDW as a supportive early marker of sepsis among adult emergency patients with suspected infection and to compare RDW with CRP and procalcitonin. Methods: This prospective cohort study was conducted in the Emergency Department of a tertiary care hospital in Lahore, Pakistan. Adult patients with suspected infection requiring sepsis workup were enrolled and classified into sepsis and non-sepsis infection groups according to Sepsis-3 criteria. Admission RDW, CRP, and procalcitonin were measured, and clinical severity indicators were recorded. Diagnostic accuracy assessment using ROC analysis was planned. Results: Patients with sepsis had higher admission RDW than non-sepsis infection patients, with reported values of 15.9 ± 1.8% and 13.7 ± 1.2%, respectively. CRP was also higher in the sepsis group, 128 ± 46 mg/L versus 54 ± 21 mg/L, and procalcitonin was 4.8 ± 2.6 ng/mL versus 0.9 ± 0.4 ng/mL. The sepsis group also had higher heart rate, lower systolic blood pressure, and higher SOFA score. Conclusion: RDW may serve as a simple, low-cost supportive marker in early sepsis assessment, but it should be interpreted alongside clinical evaluation and other biomarkers. Complete ROC statistics, cut-offs, serial RDW values, and adjusted analyses are required before firm diagnostic accuracy conclusions can be drawn
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