ROLE OF ELEVATED RED BLOOD CELL DISTRIBUTION WIDTH (RDW) COMBINED WITH ELEVATED WHITE BLOOD CELL (WBC) IN PERIPHERAL BLOOD ROUTINE IN PREDICTING MORTALITY IN ADULT COMMUNITY-ACQUIRED PNEUMONIA PATIENTS

Abstract

OBJECTIVE

To assess and contrast the predictive validity of increased Red Cell Distribution Width (RDW) in conjunction with White Blood Cell (WBC) count against the CURB-65 scoring system in predicting 30-day mortality rates among adult individuals diagnosed with community-acquired pneumonia.

STUDY DESIGN

This investigation followed a descriptive cross-sectional structure

PLACE AND DURATION OF THE STUDY

This research was executed at the Department of Pulmonology, Liaquat National Postgraduate Medical Centre, Karachi from August 2023 to May 2024

METHODOLOGY

The sample of 437 patients of community- acquired pneumonia (CAP) who were diagnosed 1 to 3 days after presentation. Eligible participants aged 18 to 65 years, of either gender, were included to determine and compare the predictive accuracy of elevated Red Blood Cell Distribution Width (RDW) combined with elevated White Blood Cell (WBC) count in peripheral blood and the CURB-65 score in predicting 30-day mortality in adult community-acquired pneumonia (CAP) patients, using 30-day mortality as the gold standard. The data was analyzed through SPSS version 26, employing both descriptive statistics and the ROC for evaluation.

RESULTS

Among a cohort of 437 individuals diagnosed with community-acquired pneumonia, the average age was calculated to be 52.40 ± 11.76 years; the distribution revealed that 61.8% were male and 38.2% were female. The combination of elevated RDW and abnormal WBC count exhibited a sensitivity of 84.81% and a diagnostic accuracy of 71.17% in forecasting 30-day mortality. Conversely, the CURB-65 scoring system manifested a greater specificity (89.94%) and overall accuracy (86.04%), albeit with a reduced sensitivity of 68.35%.

CONCLUSION

This investigation elucidated that the amalgamation of heightened RDW and WBC exhibits significant prognostic capabilities concerning 30-day mortality among CAP patients. Although the CURB-65 scoring system demonstrated superior overall diagnostic precision and specificity, the combination of RDW and WBC count revealed enhanced sensitivity and negative predictive value, indicating its potential as an early screening instrument. These results underscore the clinical importance of integrating straightforward, readily accessible hematological metrics alongside established scoring methodologies to augment mortality risk stratification.