Red Blood Cell Distribution Width Predicts Mortality in Hospitalized Patients with Severe Fever with Thrombocytopenia Syndrome

J Inflamm Res. 2024 Jul 22:17:4895-4904. doi: 10.2147/JIR.S468388. eCollection 2024.

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality rate. This study aimed to investigate the association of red blood cell distribution width (RDW) and mortality risk in hospitalized SFTS patients.

Methods: Clinical data of SFTS patients was retrospectively collected from three hospitals between October 2010 and August 2022. Cox proportional hazards model was used to identity the risk factors for fatal outcome. The predictive value of RDW for fatal outcome was evaluated by the receiver operating characteristic (ROC) analysis and Kaplan-Meier methods.

Results: Of 292 patients, the median age was 61.5 years. Non-survivors showed higher RDW value than survivors (13.6% vs.13.0%, P < 0.001). The mortality rate was 44.8% in patients with elevated RDW compared to 18.4% of patients with normal RDW, with a relative risk (RR) of 2.439. Elevated RDW was an independent risk factor of mortality (hazards ratio: 1.167, P = 0.019). Patients with elevated RDW had a higher cumulative mortality than patients with normal RDW. The area under the ROC curve (AUC) of RDW for the prediction of mortality was 0.690 (P < 0.001).

Conclusion: Elevated RDW was associated with higher mortality risk for patients hospitalized for SFTS. RDW may be helpful for risk stratification in SFTS patients.

Keywords: prognosis; red blood cell distribution width; severe fever with thrombocytopenia syndrome; survival.

Grants and funding

Dr. Rui Huang wishes to acknowledge the support from Nanjing Medical Science and Technique Development Foundation (No. QRX17121) and Natural Science Foundation of Jiangsu Province (No. BK20211004). Dr. Jie Li wishes to acknowledge the support from the National Natural Science Fund (No.81970545; 82170609), Natural Science Foundation of Shandong Province (Major Project) (No. ZR2020KH006) and Ji’nan Science and Technology Development Project (No.2020190790). Dr. Chao Wu wishes to acknowledge the support from Nanjing Important Science & Technology Specific Projects (No. 2021‐11005). Dr. Yali Xiong wishes to acknowledge the support from the Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University (2022-LCYJ-DBZ-06).