Utility of Red Blood Cell Distribution Width to Albumin Ratio and Hemoglobin to Red Blood Cell Distribution Width Ratio as Biomarkers in Pediatric Sepsis

Abstract

Objectives − The objective was to compare these parameters in children with severe and non-severe sepsis and to evaluate their utility in predicting mortality.

Material and Methods − A cross-sectional study conducted in the Pediatric Intensive Care of a dis- trict hospital in India. The hematological parameters of 54 children with severe sepsis and 55 with non-severe sepsis were analysed.

Results − The children with severe sepsis had significantly lower HRR (Hemoglobin-RDW ratio) with higher RDW, plateletcrit and RAR as compared to those with non-severe sepsis. There were no significant differences between the groups with respect to the differential and total white blood cell counts or their ratios and other platelet indices. As compared to the survivors, non-survivors had significantly lower HRR with higher RDW and RAR. At a cut-off value of 3.845, RAR was 79.2% sensitive and 59% specific and at a cut-off value of 0.712 HRR was 77.8% sensitive and 60% specific in prediction of mortality.

Conclusions − Children with severe sepsis had higher RAR and lower HRR when compared with children with non-severe sepsis. Significantly higher RAR and lower HRR were also noted among non-survivors as compared to survivors. The biomarkers RAR and HRR are readily available and useful in predicting mortality in children with sepsis.