Malnutrition: muscle wasting, inflammation, RDW, and their relation with adverse outcomes.

Carlos A Galindo-Martín, Paola A Chong-Aviña, Vilma Godinez-Breacher, Verónica A Aportela-Vázquez, Gabriela Bueno-Hernández, Ma Fernanda De Gante-García, Karen Y Pimentel-Luna, Marisol Sánchez-Abrego
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Abstract

Objective: The objective of the study was to explore red cell distribution width (RDW) as a surrogate marker of inflammation, alone and in conjunction with muscle wasting to predict malnutrition-related adverse outcomes.

Methods: This was a single-center observational study including adult hospitalized patients. Demographic variables, malnutrition criteria, and RDW were captured within 24 hours of hospital admission. Correlation tests and regression models were performed between these variables (RDW and muscle wasting) and adverse outcomes (in-hospital mortality and unplanned transfer to critical care areas (CCA).

Results: Five hundred and forty-five patients were included in the final analysis. Muscle wasting showed an independent association with adverse outcomes in every regression model tested. RDW alone showed fair predictive performance for both outcomes' significance and the adjusted model with muscle wasting showed association only for unplanned transfer to CCA.

Conclusion: RDW did not improve the prediction of adverse outcomes compared to muscle wasting assessed by physical examination and simple indexes for acute and chronic inflammation. Malnourished patients presented higher RDW values showing a possible metabolic profile (higher inflammation and lower muscle). It is still unknown whether nutrition support can influence RDW value over time as a response marker or if RDW can predict who may benefit the most from nutritional support.

营养不良:肌肉萎缩、炎症、RDW 及其与不良后果的关系。
研究目的本研究旨在探讨红细胞分布宽度(RDW)作为炎症的替代标记物,单独使用或与肌肉萎缩一起使用时如何预测与营养不良相关的不良后果:这是一项包括成年住院患者在内的单中心观察性研究。入院 24 小时内采集人口统计学变量、营养不良标准和 RDW。在这些变量(RDW和肌肉萎缩)与不良后果(院内死亡率和意外转入重症监护区(CCA))之间进行了相关性检验并建立了回归模型:最终分析共纳入了 545 名患者。在测试的每个回归模型中,肌肉萎缩都与不良预后有独立关联。单独的 RDW 对两种结果的显著性均显示出一般的预测性能,而包含肌肉萎缩的调整模型仅对意外转入 CCA 显示出相关性:结论:与通过体格检查和简单的急性和慢性炎症指标评估的肌肉萎缩相比,RDW并不能提高不良预后的预测能力。营养不良患者的 RDW 值较高,这可能与代谢情况有关(炎症较重,肌肉较少)。营养支持是否能随着时间的推移影响 RDW 值,将其作为一种反应标记,或者 RDW 是否能预测哪些人可能从营养支持中获益最多,目前还不得而知。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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