{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:11:58Z","timestamp":1793308318311,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Medicine Chiang Mai University Research Fund","award":["119\/2566"],"award-info":[{"award-number":["119\/2566"]}],"id":[{"id":"https:\/\/ror.org\/05m2fqn25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Red blood cell distribution width (RDW) and mean platelet volume (MPV) are well-established prognostic biomarkers across various medical conditions. However, their role in predicting mortality among critically ill pediatric patients remains unclear. This study investigates the association between RDW, MPV, and 28-day mortality in pediatric intensive care unit (PICU) patients. Methods: This retrospective cohort study analyzed data from children aged 1 month to 18 years who were admitted to the PICUs at Chiang Mai University Hospital for \u226524 h between January 2018 and December 2022. The primary outcome was 28-day PICU mortality. A log-binomial regression analysis was conducted to assess the association of RDW and MPV with 28-day PICU mortality, adjusting for age, sex, mechanical ventilation, vasoactive drug use, continuous renal replacement therapy, and multiorgan failure. Results: A total of 580 PICU patients were included, 55.3% male, with a median age of 5.9 (IQR: 4.7\u201310.4) months. The 28-day PICU mortality rate was 9.8% (57\/580). Respiratory failure and acute respiratory distress syndrome were the most common admission diagnoses (72.1%). Elevated RDW (\u226515%) and MPV (\u226510 fL) were independently associated with increased 28-day PICU mortality (adjusted RR: 2.73, 95% CI: 1.45\u20135.13 and 2.38, and 95% CI: 1.43\u20133.93, respectively). Both markers demonstrated high negative predictive values (RDW: 96.0% and MPV: 94.6%). Conclusions: Elevated RDW (\u226515%) and MPV (\u226510 fL) were independently associated with increased 28-day PICU mortality. These findings highlight their potential utility as accessible and cost-effective biomarkers for early risk stratification in critically ill pediatric patients.<\/jats:p>","DOI":"10.3390\/jcm14113839","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T04:27:58Z","timestamp":1748579278000},"page":"3839","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Admission Red Blood Cell Distribution Width and Mean Platelet Volume as Predictors of Mortality in the Pediatric Intensive Care Unit: A Five-Year Single-Center Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-4636","authenticated-orcid":false,"given":"Kanokkarn","family":"Sunkonkit","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatree","family":"Chai-adisaksopha","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungrote","family":"Natesirinilkul","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-6254","authenticated-orcid":false,"given":"Phichayut","family":"Phinyo","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2544-7322","authenticated-orcid":false,"given":"Konlawij","family":"Trongtrakul","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1007\/s13312-018-1285-5","article-title":"Outcome Prediction Value of Red Cell Distribution Width in Critically-ill Children","volume":"55","author":"Sachdev","year":"2018","journal-title":"Indian Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e22075","DOI":"10.1097\/MD.0000000000022075","article-title":"Evaluation of the usefulness of red blood cell distribution width in critically ill pediatric patients","volume":"99","author":"Kim","year":"2020","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1515\/med-2021-0323","article-title":"Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis","volume":"16","author":"Cai","year":"2021","journal-title":"Open Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1055\/s-0041-1730883","article-title":"Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit","volume":"13","author":"Dubey","year":"2021","journal-title":"J. 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