Red Cell Distribution Width as a Predictor of Outcome in Patients with Sepsis at the Intensive Care Unit, Obafemi Awolowo University Teaching Hospital, South West Nigeria

This study investigates the prognostic utility of red cell distribution width (RDW) for predicting clinical outcomes in sepsis patients admitted to the intensive care unit (ICU) at Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, Osun State, South West Nigeria. RDW reflects erythrocyte anisocytosis driven by inflammation, nutritional deficiency, and bone marrow stress, and its elevation has been associated with adverse outcomes in critical illness in studies from other settings, but Nigerian ICU data are absent. A prospective cohort study enrolled 150 consecutive sepsis patients meeting the Sepsis-3 definition and followed them for 28-day mortality. RDW was measured on admission and at days 3 and 7. Sequential Organ Failure Assessment (SOFA) scores were calculated, and inflammatory markers (C-reactive protein, procalcitonin) were obtained concurrently. Admission RDW above 15.5 percent was present in 58 percent of patients and was associated with significantly higher 28-day mortality (61% vs 28% in those with RDW below 15.5%). In Cox regression analysis, RDW remained an independent predictor of mortality after adjustment for SOFA score, age, and CRP. Dynamic RDW increase from admission to day 3 was a stronger predictor of mortality than static admission values. The study establishes RDW as a readily available, cost-free prognostic biomarker in Nigerian sepsis ICU settings and recommends its incorporation into sepsis risk stratification algorithms. Keywords: red cell distribution width, sepsis, ICU outcome, prognostic biomarker, Obafemi Awolowo.