Role of Red Cell Distribution Width as a Prognostic Marker in Neonatal Sepsis

Objective: To determine the prognostic value of red cell distribution width (RDW-CV%) in predicting the outcome in neonatal sepsis.Methodology: It was an observational study conducted at the Pakistan Institute of Medical Sciences, Islamabad, from December 2018 to April 2020. A total of 136 neonates at term with clinical suspicion of neonatal sepsis were equally divided based on RDW into two groups as normal and raised RDW. A complete blood count and C-reactive protein were done on the day of admission and repeated on Day 3. Outcomes were observed in terms of discharges, expiries and length of hospital stay.Results: The mean RDW of Group 1 (normal RDW) was 14.71±0.65 on Day 1 and 17.14±0.14 on Day 3 with a significant p-value of <0.001. In group 2 (Raised RDW) on Day 1 it was 17.14±1.46 and at day-3 was 17.8±1.90 with a p<0.001. Discharged neonates in group 1 were 57 (83.8%) and in group 2 were 46 (67.6%). (p=0.458). Expired neonates in Group-1 were 11(16.2%) and in group-2 were 22(32.4%) with significant p-value of 0.028. Neonates shifted to ventilator in group-1 were 10 (14.7%) and in group-2 were 24(35.3%) with p-value (0.006). Length of hospital stay in terms of days in group1 with mean 5.85± 4.03 and group-2 it was 7.63± 4.82 with a significant p-value of <0.001.Conclusion: Raised RDW in clinically septic neonates was associated with poor outcomes in terms of length of hospital stay, mechanical ventilation and deaths compared to neonates with normal RDW.Keywords: Red cell distribution width, Sepsis, Neonatal