The correlation between red cell dustribution width and in-hospital mortality in elderly patients applied to the emergency services

Öz

Aim: Red blood cell distribution width is a parameter used to in the whole blood count examination. Recent studies suggest that red blood cell distribution is associated with increased mortality in clinically significantpredictive value in mortality in many diseases. We compared the red blood cell distribution values of the patients who were discharged from the hospital and the RDW levels of the patients who were hospitalized and investigated whether they were associated with in-hospital mortality Material and Methods: This study is a cross-sectional, retrospective study performed in the emergency department. A total of 843 people (435 study(ex) group and 408 control group) who did not meet the exclusion criteria were included in the study. Red blood cell distribution values were evaluated according to the study and control groups. Results: The mean value of red blood cell distribution in the study(ex) group was found to be 16.03. In the control group, the mean value of red blood cell distribution was found to be 14.67. When compared with Mann Whitney U test, it was shown that red blood cell distribution value increased significantly in the study(ex) group compared to the control group and was associated with mortality (p <0.05) CONCLUSIONS: The mean red blood cell distribution levels were significantly higher in ex-hospital patients compared to the control group. The high red blood cell distribution value has been shown to be a predictive value for mortality.

Anahtar Kelimeler

• Emergency Medicine
• RDW
• Mortality

Acil servise başvuran yaşlı hastalarda eritorist dağılım genişliği ile hastane içi mortalitesi arasındaki ilişki

Öz

Amaç: Eritrosit dağılım genişliği tam kan sayımı incelemesinde kullanılan bir parametredir. Son çalışmalar, kırmızı kan hücresi dağılımının, birçok hastalıkta mortalitede klinik olarak anlamlı prediktif değerde artan mortalite ile ilişkili olduğunu göstermektedir. Hastaneden taburcu olan hastaların eritrosit dağılım değerleri ile hastaneye yatan hastaların RDW düzeylerini karşılaştırdık ve hastane içi mortalite ile ilişkisi olup olmadığını araştırdık. Gereç ve Yöntemler: Bu çalışma acil serviste yapılmış kesitsel retrospektif bir çalışmadır. Dışlama kriterlerini karşılamayan toplam 843 kişi (435 çalışma(eski) grubu ve 408 kontrol grubu) çalışmaya dahil edildi. Eritrosit dağılım değerleri çalışma ve kontrol gruplarına göre değerlendirildi. Sonuç: Çalışma(eski) grubunda kırmızı kan hücresi dağılımının ortalama değeri 16.03 olarak bulundu. Kontrol grubunda ortalama eritrosit dağılımı değeri 14,67 bulundu. Mann Whitney U testi ile karşılaştırıldığında çalışma(eski) grubunda kırmızı kan hücre dağılım değerinin kontrol grubuna göre anlamlı olarak arttığı ve mortalite ile ilişkili olduğu gösterildi (p <0.05) Ortalama kırmızı kan hücresi dağılım seviyeleri, kontrol grubu ile karşılaştırıldığında hastaneden ayrılan hastalarda anlamlı olarak daha yüksekti. Yüksek kırmızı kan hücresi dağılım değerinin, mortalite için öngörü değeri olduğu gösterilmiştir.

Anahtar Kelimeler

• Acil Servis
• Mortalite
• Eritorsit Dağılım Genişliği

Kaynakça

1. 1. Aung, N., Ling, H.Z., Cheng, A.S. et al, Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure. Int J Cardiol. 2013;168:1997–2002.
2. 2. Ani, C.,& Ovbiagele, B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. Journal of the neurological sciences. 2009; 277(1), 103-108.
3. 3. Jo, Y. H., Kim, K., Lee, J. H., Kang, C., Kim, T., Park, H. M., ... & Rhee, J. E. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. The American journal of emergency medicine.2013; 31(3), 545-548.
4. 4. Ku, N. S., Kim, H. W., Oh, H. J., Kim, Y. C., Kim, M. H., Song, J. E., ... & Han, S. H. Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. Shock. 2012; 38(2), 123-127.
5. 5. Braun, E., Kheir, J., Mashiach, T., Naffaa, M., & Azzam, Z. S. Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia?. BMC infectious diseases.2014;14(1), 129.
6. 6. 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. Annals of medicine. 2011; 43(1), 40-46.
7. 7. Felker, G. M., Allen, L. A., Pocock, S. J., Shaw, L. K., McMurray, J. J., Pfeffer, M. A., ... & Granger, C. B. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. Journal of the American College of Cardiology. 2007; 50(1), 40-47.
8. 8. Patel, K. V., Ferrucci, L., Ershler, W. B., Longo, D. L., & Guralnik, J. M. Red blood cell distribution width and the risk of death in middle-aged and older adults. Archives of internal medicine.2009; 169(5), 515-523.

9. 9. Nishizaki, Y., Yamagami, S., Suzuki, H., Joki, Y., Takahashi, S., Sesoko, M., ... & Daida, H. Red blood cell distribution width as an effective tool for detecting fatal heart failure in super-elderly patients. Internal Medicine.2012; 51(17), 2271-2276.
10. 10. Tonelli, M., Sacks, F., Arnold, M., Moye, L., Davis, B., & Pfeffer, M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation.2008; 117(2), 163-168.
11. 11. Cakal, B., Akoz, A. G., Ustundag, Y., Yalinkilic, M., Ulker, A., & Ankarali, H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Digestive diseases and sciences.2009; 54(4), 842-847.
12. 12. Malandrino, N., Wu, W. C., Taveira, T. H., Whitlatch, H. B., & Smith, R. J. Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes. Diabetologia.2012; 55(1), 226-235.
13. 13. Şenol, K., Saylam, B., Kocaay, F., & Tez, M. Red cell distribution width as a predictor of mortality in acute pancreatitis. The American journal of emergency medicine.2013; 31(4), 687-689.
14. 14. Sičaja, M., Pehar, M., Đerek, L., Starčević, B., Vuletić, V., Romić, Ž., & Božikov, V. Red blood cell distribution width as a prognostic marker of mortality in patients on chronic dialysis: a single center, prospective longitudinal study. Croatian medical journal;2013; 54(1), 25-32.
15. 15. Osadnik T, Strzelczyk J, Hawranek M, et al. Red cell distribution width is associated with long-term prognosis in patients with stable coronary artery disease. BMC Cardiovasc Disord. 2013; 13: 113-21.
16. 16. Lam, A. P., Gundabolu, K., Sridharan, A., Jain, R., Msaouel, P., Chrysofakis, G., ... & Verma, A. K. Multiplicative interaction between mean corpuscular volume and red cell distribution width in predicting mortality of elderly patients with and without anemia. American journal of hematology. 2013; 88(11).
17. 17. Zalawadiya, S. K., Veeranna, V., Panaich, S. S., Afonso, L., & Ghali, J. K. Gender and ethnic differences in red cell distribution width and its association with mortality among low risk healthy United State adults. American Journal of Cardiology. 2012; 109(11), 1664-1670.
18. 18. Arbel, Y., Weitzman, D., Raz, R., Steinvil, A., Zeltser, D., Berliner, S., ... & Shalev, V. Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality. Thrombosis and haemostasis. 2014; 112(02), 300-307.
19. 19. Spell, D. W., Jones, D. V., Harper, W. F., & Bessman, J. D. The value of a complete blood count in predicting cancer of the colon. Cancer detection and prevention. 2004; 28(1), 37-42.
20. 20. Baicus, C., Caraiola, S., Rimbas, M., Patrascu, R., & Baicus, A. Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss. Journal of Investigative Medicine. 2011; 59(6), 951-955.
21. 21. Koma, Y., Onishi, A., Matsuoka, H., Oda, N., Yokota, N., Matsumoto, Y., ... & Yoshimatsu, H. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PloS one. 2013; 8(11), e80240.
22. 22. Tanindi, A., Topal, F. E., Topal, F., & Celik, B. Red cell distribution width in patients with prehypertension and hypertension. Blood pressure. 2012;21(3), 177-181.
23. 23. Bilal, A., Farooq, J. H., Kiani, I., Assad, S., Ghazanfar, H., & Ahmed, I. Importance of mean red cell distribution width in hypertensive patients. Cureus. 2016; 8(11).
24. 24. Çetin, M., Kocaman, S. A., Bostan, M., Çanga, A., Çiçek, Y., Erdoğan, T., ... & Uğurlu, Y. Red blood cell distribution width (RDW) and its association with coronary atherosclerotic burden in patients with stable angina pectoris. European Journal of General Medicine. 2012; 9(1).
25. 25. Wang, Y. L., Hua, Q., Bai, C. R., & Tang, Q. Relationship between red cell distribution width and short-term outcomes in acute coronary syndrome in a Chinese population. Internal Medicine. 2011;50(24), 2941-2945.
26. 26. Lappé, J. M., Horne, B. D., Shah, S. H., May, H. T., Muhlestein, J. B., Lappé, D. L., ... & Bair, T. L. Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population. Clinica chimica açta. 2011; 412(23-24), 2094-2099.
27. 27. Solak, Y., Gaipov, A., Turk, S., Kayrak, M., Yilmaz, M. I., Caglar, K., ... & Cetinkaya, H. Red cell distribution width is independently related to endothelial dysfunction in patients with chronic kidney disease. The American journal of the medical sciences.2014; 347(2), 118-124.
28. 28. Mucsi, I., Ujszaszi, A., Czira, M. E., Novak, M., & Molnar, M. Z. Red cell distribution width is associated with mortality in kidney transplant recipients. International urology and nephrology.2014; 46(3), 641-651.
29. 29. Ramírez‐Moreno, J. M., Gonzalez‐Gomez, M., Ollero‐Ortiz, A., Roa‐Montero, A. M., Gómez‐Baquero, M. J., & Constantino‐Silva, A. B. Relation between red blood cell distribution width and ischemic stroke: a case‐control study. International Journal of Stroke.2013; 8(6).
30. 30. Kara, M., Uysal, S., Altinişik, U., Cevizci, S., Güçlü, O., & Dereköy, F. S. The pre-treatment neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red cell distribution width predict prognosis in patients with laryngeal carcinoma. European Archives of Oto-Rhino-Laryngology.2017; 274(1), 535-542.