Is red blood cell distribution width an indicator of prognosis and mortality in respiratory intensive care unit?

Year 2021, Volume: 7 Issue: 6, 610 - 616, 04.11.2021

Güler Eraslan Doğanay , Mustafa Özgür Cırık

https://doi.org/10.18621/eurj.878028

Abstract

Objectives: The range of variation of erythrocytes measured as Red blood cell distribution width (RDW). Mortality indicators in patients in intensive care depend on variation of physiological variables. High RDW rates have been commonly associated with heart disease, pulmonary embolism and pulmonary hypertension, peripheral artery disease, heart failure, liver disease and infectious diseases. We aimed in this study to determine the effect of RDW on prognosis and mortality in Chronic Obstructive Pulmonary Disease (COPD) patients in intensive care unit (ICU).

Methods: The cases who are treated for COPD in ICU between January 1, 2018 and December 31, 2019 reviewed. Demographic data, Charlson Comorbidite Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores, procalcitonin, white blood cell, RDW, C-reactive protein, duration of mechanical ventilation, inotrope requirement, length of stay ICU, and 30-day mortality reviewed.

Results: Total number of 369 cases are included into the study and divided in two groups according to their RDW values (High RDW and normal RDW group). High RDW group had longer length of stay in ICU and hospital, mechanical ventilation duration, higher APACHE II, CCI, SOFA, white blood cell and procalcitonin values and lower C-reactive protein compared to normal RDW group. First outcome was hospital 30-day mortality in ICU. The age, RDW, inotrope use, MV duration, LOS H, APACHE II, CCI, SOFA, procalcitonin, CRP, HGB and HCT levels were found to be higher in patients with mortality compared those without. With the sensitivity value of 70.9% and the specificity of 47.7%, RDW the cut off value was found to be 16.5.

Conclusions: The risk of 30-day mortality, length of stay ICU and hospital and mechanical ventilation duration was higher in COPD patients with high RDW levels.

Keywords

RDW, ICU, COPD, Mortality, Respiratory ıcu, Indicator

Thanks

Dear Editor, Attached please find our manuscript titled “Is RDW an Indicator of Prognosis and Mortality In Respiratory ICU ?” on behalf of consideration for publication in “The European Research Journal” as an article. Mortality indicators in intensive care are still an important study subject. We believe that this study will contribute to clinical practice and suitable for this journal. The work has not been published elsewhere and is not under consideration for publication elsewhere. All authors agree with and responsible for the data presented. No conflict of interest, financial or other, exists. Thank you for the consideration. Mustafa Ozgur Cirik

References

• 1. Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR., eds., Henry’s Clinical Diagnosis and Management by Laboratory Methods, Chapter 30, Elsevier Saunders: Philadelphia, 2011: pp.509-35.
• 2. Sangoi MB, Da Silva SH, da Silva JE, Moresco RN. Relation between red blood cell distribution width and mortality after acute myocardial infarction. Int J Cardiol 2011;146:278-80.
• 3. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Jaetnoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009;158:659-66.
• 4. Hampole CV, Mehrotra AK, Thenappan T, Gomberg-Maitland M, Shah SJ. Usefulness of red cell distribution width as a prognostic marker in pulmonary hypertension. Am J Cardiol 2009;104:868-72.
• 5. Zorlu A, Bektasoglu G, Guven FM, Dogan OT, Gucuk E, Refiker M, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol 2012;109:128-34.
• 6. Ye Z, Smith C, Kullo IJ . Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol 2011;107:1241-5.
• 7. Lou Y, Wang M, Mao W .Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B. PLoS One 2012;7:e37644.
• 8. Wang F, Pan W, Pan S, Ge J, Wang S, Chen M. Red cell distribution width as a novel predictor of mortality in ICU patients. Ann Med 2011;43:40-6.
• 9. Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB .Red cell distribution width and all-cause mortality in critically ill patients. Crit Care Med 2011;39:1913-21.
• 10. Lee JH, Chung HJ, Kim K, Jo YH, Rhee JE,Kim YJ, et al. Red cell distribution width as a prognostic marker in patients with community-acquired pneumonia.Am J Emerg Med 2013;31:72-9.
• 11. Ku NS, Kim HW, Oh HJ, Kim YC, Kim MH, Song JE, et al. Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. Shock 2012;38:123-7.
• 12. Scharte M, Fink MP. Red blood cell physiology in critical illness. Crit Care Med 2003;31:S651-7.
• 13. Osadnik T, Strzelczyk J, Hawranek M, Lekston A, Wasilewski J, Kurek A, et al. Red cell distribution width is associated with long-term prognosis in patients with stable coronary artery disease. BMC Cardiovasc Disord 2013;13:113.
• 14. Lorente L, Martın MM, Gonzalez P, Violan JS, Ferreres J, Labarta L, et al. Red blood cell distribution width during the first week is associated with severity and mortality in septic patients. Plos One 2014;9:e105436.
• 15. Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, et al. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med 2013;31:545-8.
• 16. Sadaka F, O'Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med 2013;28:307-13.
• 17. Budak YU, Huysal K, Gecgel SK, Ari H, Melek M, Yavuz S, et al. Red cell distribution width, other hematological parameters and atherogenic index of plasma in patients with clopidogrel and aspirin resistance. Eur Res J 2016;2:200-5.
• 18. Zhang Z, Xu X, Ni H, Deng H. Red cell distribution width is associated with hospital mortality in unselected critically ill patients. J Thorac Dis 2013;5:730-6.