Can red cell distribution width (RDW) and immature granulocyte parameters predict mortality in patients with pleural effusion?

Year 2025, Volume: 6 Issue: 4, 428 - 433, 31.08.2025

İsmail Dal , Sedat Gülten

https://doi.org/10.47582/jompac.1752646

Abstract

Aims: Pleural effusion is a frequent clinical manifestation with variable etiologies and prognoses. Identifying reliable, accessible prognostic biomarkers is critical for early risk stratification. This study aimed to assess the prognostic significance of red cell distribution width (RDW) and immature granulocyte (IG) parameters in predicting in-hospital mortality in patients with pleural effusion.
Methods: A retrospective analysis was conducted on 107 adult patients who underwent diagnostic thoracentesis. Hematologic data including RDW-CV, RDW-SD, IG percentage (IG%), and IG absolute count (IG#) were obtained within 24 hours of thoracentesis. Patients were categorized based on in-hospital survival status. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive performance of these parameters.
Results: In-hospital mortality occurred in 21.5% of patients. Non-survivors exhibited significantly higher RDW-CV, RDWSD, IG%, and IG# values (p<0.001 for all). RDW-CV demonstrated the highest prognostic accuracy (AUC=0.793), with an optimal cut-off value of 16.1% (sensitivity: 70.2%, specificity: 82.6%). RDW-SD showed an AUC of 0.782, with a cut-off of 55.8 fL (sensitivity: 88.1%, specificity: 60.9%). Among IG parameters, IG% (AUC=0.770) had a cut-off of 1.1% (sensitivity: 81.0%, specificity: 65.2%) and IG# (AUC=0.752) had a cut-off of 0.055×10³/μL (sensitivity: 61.9%, specificity: 87.0%).
Conclusion: Elevated RDW and IG parameters independently predict in-hospital mortality in patients with pleural effusion. These readily available and cost-effective markers may serve as valuable tools for early prognostic assessment, particularly in settings where advanced diagnostic resources are limited.

Keywords

Pleural effusion , red cell distribution width , immature granulocytes , prognostic biomarkers , in-hospital mortality , hematologic indices

Ethical Statement

This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Ethics Committee of [Institution Name] (Approval No: 2022-KAEK-117). Due to the retrospective nature of the study, the requirement for written informed consent was waived by the ethics committee. All patient data were anonymized and handled with strict confidentiality throughout the study.

Thanks

Prof. Dr. Osman Güler

RDW ve olgunlaşmamış granülosit parametreleri plevral efüzyonlu hastalarda mortaliteyi öngörebilir mi?

Abstract

Arka Plan:
Plevral efüzyon, çeşitli etiyolojilere ve prognozlara sahip sık görülen bir klinik tablodur. Erken risk sınıflandırması için güvenilir ve kolay erişilebilir prognostik biyobelirteçlerin belirlenmesi büyük önem taşır. Bu çalışmada, kırmızı hücre dağılım genişliği (RDW) ve olgunlaşmamış granülosit (IG) parametrelerinin plevral efüzyonlu hastalarda hastane içi mortaliteyi öngörmedeki prognostik değeri değerlendirildi.
Yöntem:
Tanısal torasentez yapılan 107 yetişkin hastanın verileri retrospektif olarak analiz edildi. RDW-CV, RDW-SD, IG yüzdesi (IG%) ve IG mutlak sayısı (IG#) dahil olmak üzere hematolojik veriler torasentezden sonraki 24 saat içinde elde edildi. Hastalar hastane içi sağkalım durumuna göre gruplandırıldı. Bu parametrelerin prediktif performansı ROC eğrisi analizi ile değerlendirildi.
Bulgular:
Hastaların %21,5’i hastane süresince hayatını kaybetti. Kaybedilen hastalarda RDW-CV, RDW-SD, IG% ve IG# değerleri anlamlı olarak daha yüksekti (tümünde p < 0.001). En yüksek prognostik doğruluğu RDW-CV gösterdi (AUC = 0.793); optimal eşik değeri %16.1 (duyarlılık: %70.2, özgüllük: %82.6) olarak saptandı. RDW-SD için AUC 0.782, eşik değeri 55.8 fL (duyarlılık: %88.1, özgüllük: %60.9) idi. IG% için AUC 0.770 (eşik: %1.1; duyarlılık: %81.0, özgüllük: %65.2) ve IG# için AUC 0.752 (eşik: 0.055 ×10³/μL; duyarlılık: %61.9, özgüllük: %87.0) olarak bulundu.
Sonuç:
RDW ve IG parametrelerindeki yükseklik, plevral efüzyonlu hastalarda hastane içi mortaliteyi bağımsız olarak öngörebilmektedir. Bu kolay ulaşılabilir ve düşük maliyetli belirteçler, özellikle ileri tanısal araçlara erişimin kısıtlı olduğu ortamlarda, erken prognostik değerlendirmede değerli birer araç olabilir.

Keywords

Plevral efüzyon , Kırmızı hücre dağılım genişliği , Olgunlaşmamış granülositler , Prognostik biyobelirteçler , Hastane içi mortalite , Hematolojik indeksler , Risk sınıflandırması.

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