Prognostic value of albumin-red cell distribution width score in patients with severe community-acquired pneumonia.

Background: It has been recently reported that albumin (ALB) and red cell distribution width (RDW) are correlated with the prognosis of community-acquired pneumonia, while their role in severe communityacquired pneumonia (sCAP) is unknown. This study aimed to investigate the correlation between the ALBRDW score and 90-day mortality of sCAP patients.

Methods: A total of 179 sCAP patients admitted to our hospital between January 1, 2014 and June 30, 2019 were enrolled in this study. Data of patient characteristics and laboratory data were obtained and CURB-65 was calculated. The ALB-RDW score was calculated based on serum ALB and RDW. Receiver operating characteristic (ROC) curve and the value of area under the curve (AUC) were used to evaluate the association between ALB-RDW score and 90-day mortality of sCAP patients.

Results: Compared with survivors, age, white blood cell counts, neutrophil counts, RDW, D-dimer, serum creatinine, lactic dehydrogenase, CURB-65 score, ALB-RDW high score ratio, invasive ventilation and septic shock were higher in non-survivors, while ALB and hemoglobin (HB) were lower. Multivariate logistic regression analysis identified that high age, serum creatinine, ALB-RDW score and invasive ventilation were the independent risk factors of 90-day mortality (P<0.05). Moreover, the AUC of ALB-RDW score was 0.742 [95% confidence interval (CI): 0.667-0.817], which was superior to CURB-65 score 0.725 (95% CI: 0.651-0.798). The AUC increased to 0.798 (95% CI: 0.733-0.862) when combined with CURB-65 score.

Conclusions: High age, serum creatinine, ALB-RDW score and invasive ventilation were the independent risk factors of 90-day mortality of sCAP patients. In addition, the correlation between ALB-RDW and 90-day mortality was even stronger when combined with CURB-65 score.