{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:34:17Z","timestamp":1784010857465,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Epidemiological studies have demonstrated an association between red blood cell distribution width (RDW) and the prognosis of pneumonia-associated diseases. However, prognostic value of RDW in patients with ventilator-associated pneumonia (VAP) has yet to be investigated. This study aimed to explore the association between RDW and in-hospital mortality in VAP patients and explore predictive value of RDW for VAP patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective cohort study included 1,543 VAP patients from the Medical Information Mart for Intensive Care IV database 2008-2019. The primary outcome was considered to 30-day in-hospital mortality of VAP patients in this study. Non-high RDW level group was defined as &lt;15 %, and high RDW level group as \u226515%. The possible confounding factors were screened by least absolute shrinkage and selection operator regression. Univariate and multivariate COX regression analyses were used for the assessment on the association of RDW and 30-day in-hospital mortality in VAP patients. We also performed subgroup analyses. Furthermore, a comparative analysis of RDW and sequential organ failure assessment (SOFA) score and simplified acute physiology score II (SAPS II) were performed by receiver operating characteristic (ROC) curves.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The 30-day in-hospital mortality of VAP patients was approximately 19.05%. After adjusting all confounding factors, high RDW was associated with 30-day in-hospital mortality among VAP patients by using non-high RDW as the reference [hazard ratio (HR) =1.29, 95% confidence interval (CI): 1.01-1.63]. Additionally, the relationship was also robust in several populations, such as patients were younger than 60 years, or had not a history of congestive heart failure, or had a history of sepsis, or had not received renal replacement therapy, or had a duration of mechanical ventilation for more than 7 days. The result of ROC indicated that RDW had a better prognostic value in predicting 30-day in-hospital mortality for VAP patients than SOFA score and SAPS II score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>High RDW level is associated with an increased 30-day in-hospital mortality. The RDW is a promising biomarker in predicting 30-day in-hospital mortality for patients admitted to the ICU, regardless of VAP.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-023-08692-0","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T14:02:35Z","timestamp":1697637755000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Relation between red blood cell distribution width and 30-day in-hospital mortality of patients with ventilator-associated pneumonia"],"prefix":"10.1186","volume":"23","author":[{"given":"Zhonghua","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"8692_CR1","doi-asserted-by":"publisher","first-page":"715566","DOI":"10.3389\/fpubh.2022.715566","volume":"10","author":"Y Yin","year":"2022","unstructured":"Yin Y, Sun M, Li Z, Bu J, Chen Y, Zhang K, et al. Exploring the nursing factors related to ventilator-associated pneumonia in the intensive care unit. Front Public Health. 2022;10:715566.","journal-title":"Front Public Health."},{"key":"8692_CR2","doi-asserted-by":"publisher","first-page":"633","DOI":"10.3949\/ccjm.87a.19117","volume":"87","author":"AR Modi","year":"2020","unstructured":"Modi AR, Kovacs CS. Hospital-acquired and ventilator-associated pneumonia: diagnosis, management, and prevention. Cleve Clin J Med. 2020;87:633\u20139.","journal-title":"Cleve Clin J Med."},{"key":"8692_CR3","doi-asserted-by":"publisher","first-page":"670","DOI":"10.21037\/atm.2020.03.173","volume":"8","author":"T McEnery","year":"2020","unstructured":"McEnery T, Martin-Loeches I. Predicting ventilator-associated pneumonia. Ann Transl Med. 2020;8:670.","journal-title":"Ann Transl Med."},{"key":"8692_CR4","doi-asserted-by":"publisher","first-page":"8822","DOI":"10.3390\/ijerph19148822","volume":"19","author":"S Kwak","year":"2022","unstructured":"Kwak S, Han S. Development of a tool for measuring ventilator-associated pneumonia prevention behaviors of intensive care unit nurses. Int J Environ Res Public Health. 2022;19:8822.","journal-title":"Int J Environ Res Public Health."},{"key":"8692_CR5","first-page":"2431","volume":"26","author":"B Kavvasoglu","year":"2022","unstructured":"Kavvasoglu B, Akdemir SN, Kurt M. A routine but overlooked parameter for impaired glucose control: red cell distribution width. Eur Rev Med Pharmacol Sci. 2022;26:2431\u20136.","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"8692_CR6","doi-asserted-by":"publisher","first-page":"413","DOI":"10.2147\/JBM.S367660","volume":"13","author":"M Arkew","year":"2022","unstructured":"Arkew M, Gemechu K, Haile K, Asmerom H. Red blood cell distribution width as novel biomarker in cardiovascular diseases: a literature review. J Blood Med. 2022;13:413\u201324.","journal-title":"J Blood Med."},{"key":"8692_CR7","first-page":"21","volume":"31","author":"C Y\u00fcksel","year":"2021","unstructured":"Y\u00fcksel C, Er\u015fen O, Culcu S, Bak\u0131rarar B, Unal AE, Demirci S. Prognostic Role of Red Distribution Width (RDW) value in gastric cancer. J Coll Physicians Surg Pak. 2021;31:21\u20136.","journal-title":"J Coll Physicians Surg Pak."},{"key":"8692_CR8","doi-asserted-by":"publisher","first-page":"581","DOI":"10.21037\/atm.2019.09.58","volume":"7","author":"C Fava","year":"2019","unstructured":"Fava C, Cattazzo F, Hu ZD, Lippi G, Montagnana M. The role of red blood cell distribution width (RDW) in cardiovascular risk assessment: useful or hype? Ann Transl Med. 2019;7:581.","journal-title":"Ann Transl Med."},{"key":"8692_CR9","doi-asserted-by":"publisher","first-page":"393","DOI":"10.2147\/COPD.S291833","volume":"16","author":"M Zhu","year":"2021","unstructured":"Zhu M, Dai L, Wan L, Zhang S, Peng H. Dynamic increase of red cell distribution width predicts increased risk of 30-day readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2021;16:393\u2013400.","journal-title":"Int J Chron Obstruct Pulmon Dis."},{"key":"8692_CR10","first-page":"4258","volume":"26","author":"M Deniz","year":"2022","unstructured":"Deniz M, Ozgun P, Ozdemir E. Relationships between RDW, NLR, CAR, and APACHE II scores in the context of predicting the prognosis and mortality in ICU patients. Eur Rev Med Pharmacol Sci. 2022;26:4258\u201367.","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"8692_CR11","doi-asserted-by":"publisher","first-page":"8024024","DOI":"10.1155\/2021\/8024024","volume":"2021","author":"Q Ren","year":"2021","unstructured":"Ren Q, Liu H, Wang Y, Dai D, Tian Z, Jiao G, et al. The role of red blood cell distribution width in the severity and prognosis of community-acquired pneumonia. Can Respir J. 2021;2021:8024024.","journal-title":"Can Respir J."},{"key":"8692_CR12","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s40121-022-00736-3","volume":"12","author":"L He","year":"2023","unstructured":"He L, Yang D, Ding Q, Su Y, Ding N. Association between lactate and 28-day mortality in elderly patients with sepsis: results from MIMIC-IV Database. Infect Dis Ther. 2023;12:459\u201372.","journal-title":"Infect Dis Ther."},{"key":"8692_CR13","doi-asserted-by":"publisher","first-page":"548","DOI":"10.33314\/jnhrc.v17i4.1042","volume":"17","author":"B Shrestha","year":"2020","unstructured":"Shrestha B, Dunn L. The declaration of helsinki on medical research involving human subjects: a review of seventh revision. J Nepal Health Res Counc. 2020;17:548\u201352.","journal-title":"J Nepal Health Res Counc."},{"key":"8692_CR14","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.2217\/bmm-2020-0041","volume":"14","author":"Z Wang","year":"2020","unstructured":"Wang Z, Korantzopoulos P, Roever L, Liu T. Red blood cell distribution width and atrial fibrillation. Biomark Med. 2020;14:1289\u201398.","journal-title":"Biomark Med."},{"key":"8692_CR15","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1186\/s12872-022-02875-4","volume":"22","author":"Y Liao","year":"2022","unstructured":"Liao Y, Zhang R, Shi S, Lin X, Wang Y, Wang Y, et al. Red blood cell distribution width predicts gastrointestinal bleeding after coronary artery bypass grafting. BMC Cardiovasc Disord. 2022;22:436.","journal-title":"BMC Cardiovasc Disord."},{"issue":"Suppl 1","key":"8692_CR16","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/0736-4679(91)90592-4","volume":"9","author":"TC Evans","year":"1991","unstructured":"Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med. 1991;9(Suppl 1):71\u20134.","journal-title":"J Emerg Med."},{"key":"8692_CR17","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2991\/chi.k.210404.001","volume":"3","author":"M Lagadinou","year":"2021","unstructured":"Lagadinou M, Gkentzi D, Marangos MN, Paliogianni F, Solomou EE. Red blood cell distribution width: another prognostic factor for COVID-19? Clin Hematol Int. 2021;3:69\u201371.","journal-title":"Clin Hematol Int."},{"key":"8692_CR18","doi-asserted-by":"publisher","first-page":"2597","DOI":"10.2147\/IJGM.S354569","volume":"15","author":"Y Li","year":"2022","unstructured":"Li Y, Li Z, Zhang G. Clinical utility of red blood cell distribution width for the diagnosis and prognosis of cervical cancer. Int J Gen Med. 2022;15:2597\u2013606.","journal-title":"Int J Gen Med."},{"key":"8692_CR19","doi-asserted-by":"publisher","first-page":"154069","DOI":"10.1016\/j.jcrc.2022.154069","volume":"71","author":"V Moreno-Torres","year":"2022","unstructured":"Moreno-Torres V, Royuela A, M\u00fa\u00f1ez-Rubio E, Gutierrez-Rojas \u00c1, Mills-S\u00e1nchez P, Ortega A, et al. Red blood cell distribution width as prognostic factor in sepsis: a new use for a classical parameter. J Crit Care. 2022;71:154069.","journal-title":"J Crit Care."},{"key":"8692_CR20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.cca.2019.08.008","volume":"498","author":"YQ Han","year":"2019","unstructured":"Han YQ, Yan L, Zhang L, Ouyang PH, Li P, Goyal H, et al. Red blood cell distribution width provides additional prognostic value beyond severity scores in adult critical illness. Clin Chim Acta. 2019;498:62\u20137.","journal-title":"Clin Chim Acta."},{"key":"8692_CR21","doi-asserted-by":"publisher","first-page":"868920","DOI":"10.3389\/fphar.2022.868920","volume":"13","author":"L Zhang","year":"2022","unstructured":"Zhang L, Li S, Yuan S, Lu X, Li J, Liu Y, et al. The association between bronchoscopy and the prognoses of patients with ventilator-associated pneumonia in intensive care units: a retrospective study based on the MIMIC-IV database. Front Pharmacol. 2022;13:868920.","journal-title":"Front Pharmacol."},{"key":"8692_CR22","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.21037\/apm-22-502","volume":"11","author":"X Han","year":"2022","unstructured":"Han X, Wu W, Zhao H, Wang S. Developing and validating a prediction model for in-hospital mortality in patients with ventilator-associated pneumonia in the ICU. Ann Palliat Med. 2022;11:1799\u2013810.","journal-title":"Ann Palliat Med."},{"key":"8692_CR23","doi-asserted-by":"publisher","first-page":"869499","DOI":"10.3389\/fphar.2022.869499","volume":"13","author":"R Yang","year":"2022","unstructured":"Yang R, Huang T, Shen L, Feng A, Li L, Li S, et al. The use of antibiotics for ventilator-associated pneumonia in the MIMIC-IV database. Front Pharmacol. 2022;13:869499.","journal-title":"Front Pharmacol."},{"key":"8692_CR24","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.jcrc.2016.09.003","volume":"37","author":"J Larsson","year":"2017","unstructured":"Larsson J, Itenov TS, Bestle MH. Risk prediction models for mortality in patients with ventilator-associated pneumonia: a systematic review and meta-analysis. J Crit Care. 2017;37:112\u20138.","journal-title":"J Crit Care."},{"issue":"523","key":"8692_CR25","first-page":"e1","volume":"27","author":"L Boeck","year":"2012","unstructured":"Boeck L, Eggimann P, Smyrnios N, Pargger H, Thakkar N, Siegemund M, et al. The sequential organ failure assessment score and copeptin for predicting survival in ventilator-associated pneumonia. J Crit Care. 2012;27(523):e1-9.","journal-title":"J Crit Care."},{"key":"8692_CR26","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1159\/000088708","volume":"73","author":"G Gursel","year":"2006","unstructured":"Gursel G, Demirtas S. Value of APACHE II, SOFA and CPIS scores in predicting prognosis in patients with ventilator-associated pneumonia. Respiration. 2006;73:503\u20138.","journal-title":"Respiration."},{"key":"8692_CR27","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1097\/01.CCM.0000114810.30477.C3","volume":"32","author":"AF Shorr","year":"2004","unstructured":"Shorr AF, Duh MS, Kelly KM, Kollef MH. Red blood cell transfusion and ventilator-associated pneumonia: a potential link? Crit Care Med. 2004;32:666\u201374.","journal-title":"Crit Care Med."},{"key":"8692_CR28","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1177\/0885066616652612","volume":"33","author":"TMN Otero","year":"2018","unstructured":"Otero TMN, Yeh DD, Bajwa EK, Azocar RJ, Tsai AL, Belcher DM, et al. Elevated red cell distribution width is associated with decreased ventilator-free days in critically Ill patients. J Intensive Care Med. 2018;33:241\u20137.","journal-title":"J Intensive Care Med."},{"key":"8692_CR29","first-page":"e67","volume":"9","author":"S Jandaghian","year":"2021","unstructured":"Jandaghian S, Vaezi A, Manteghinejad A, Nasirian M, Vaseghi G, Haghjooy Javanmard S. Red Blood Cell distribution width (RDW) as a predictor of in-hospital mortality in COVID-19 patients; a cross sectional study. Arch Acad Emerg Med. 2021;9:e67.","journal-title":"Arch Acad Emerg Med."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08692-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-023-08692-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08692-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T17:06:09Z","timestamp":1700499969000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-023-08692-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["8692"],"URL":"https:\/\/doi.org\/10.1186\/s12879-023-08692-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]},"assertion":[{"value":"15 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement of ethical approval for this was waived by the Institutional Review Board of Taicang First People's Hospital, because the data was accessed from NHANES (a publicly available database). Written informed consent was not required as this study was based on publicly available data. All methods were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"696"}}