Prognostic values of red blood cell distribution width, platelet count, and red cell distribution width-to-platelet ratio for severe burn injury

Abstract

Red blood cell distribution width (RDW), platelet count (PLT), and a RDW-to-PLT ratio (RPR) have been associated with inflammatory activity and adverse outcomes in many diseases. This study has aimed to investigate the association between these indicators and the mortality rate of severe burn patients. From 2008 to 2014, 610 cases of severe burn patients from two burn centers in eastern China were enrolled in this study. Eighty-eight patients died within 90 days after admission. The RDW, PLT, and RPR were studied through Cox regression analysis on the 3rd and 7th day. The RDW, PLT, and RPR values on the 3rd and 7th day were significantly associated with the outcomes of severe burn patients (P < 0.01). High RPR was significantly associated with a 90-day mortality rate at the two time points. However, the RDW and PLT did not provide independent predictive values. Our results indicated that the RPR values on the 3rd and 7th day were associated with the mortality rates of severe burn patients (P < 0.01). Meanwhile, the RDW and PLT values at these time points failed to provide independent values for burn mortality prediction. Thus, the RPR can serve as an independent and novel marker for mortality rates prediction in severe burn patients.

Figure 1

(A) Receiver operating characteristic curve of RDW (AUC = 0.659; 95% CI: 0.597–0.720), PLT (AUC = 0.697; 95% CI: 0.632–0.761), and RPR (AUC = 0.712; 95% CI: 0.649–0.774) on day 3 for prediction of adverse endpoint at 90 days. (B) Receiver operating characteristic curve of RDW (AUC = 0.681; 95% CI: 0.613–0.750), PLT (AUC = 0.744; 95% CI: 0.670–0.818), and RPR (AUC = 0.750; 95% CI: 0.678–0.821) on day 7 for the prediction of adverse endpoint at 90 days.

Figure 2

(A) Kaplan–Meier survival curves for RPR higher or lower than 0.197 at day 3. (B) Kaplan–Meier survival curves for RPR higher or lower than 0.108 on day 7.