Clinical Utility of Red Blood Cell Distribution Width Parameter in Patients with Hemodynamically Stable Acute Pulmonary Embolism

Abstract

Objective: Patients with acute pulmonary embolism (PE) presenting with persistent hypotension or shock are considered to be high-risk, while hemodynamically stable patients with acute PE are classified as low-or moderate-risk, depending on their right ventricular dysfunction and/or levels of biomarkers indicating myocardial injury. In this study, we assessed the clinical benefits of knowing the red cell distribution width (RDW) parameter in patients with hemodynamically stable acute PE.Methods: All patients diagnosed with acute PE in our hospital between 2008 and 2010 were retrospectively included in the study. Patients with hypotension, a history of malignancy, heart failure, and/or anemia were excluded. Patients with normotensive acute PE were divided into either a low-or moderate-risk group. This classification was made according to echocardiographic right ventricular dysfunction, positive troponin T, and the level of NT-proBNP. Red cell distribution width values of low and moderate acute PE risk groups were compared.Results: Thirty-two patients were assessed as moderate-risk and 34 patients were low-risk PE. Red cell distribution width values of the moderate-risk group were significantly higher than those of the low-risk group (14.77±0.54 vs. 14.09±0.43; p=0.036, respectively). Conclusion:Analysis of RDW values can help to determine the low and moderate risk levels of hemodynamically stable patients with acute PE.