Increased red cell distribution width: A novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease

Epstein, Danny; Nasser, Roni; Mashiach, Tanya; Azzam, Zaher S.; Berger, Gidon

doi:10.1016/j.rmed.2018.01.011

Cited by 48 publications

(61 citation statements)

References 23 publications

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“…In one study, an increased RDW was found to be compatible with previous studies reporting a correlation between RDW and stable COPD severity (42). In another study increased RDW was reported as an independent negative prognostic factor associated with adverse outcomes after hospitalization due to acute exacerbation of COPD (43). We also found higher RDW levels in COPD patients with acute exacerbation than in stable patients in the present study.…”

Section: Discussionmentioning

confidence: 99%

Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

Şahin

Koşar

Aslan

et al. 2019

Journal of Medical Biochemistry

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Summary Background Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have all been investigated as novel inflammatory markers of cardiac and oncological diseases, while there is only a limited number of studies investigating these markers in chronic obstructive pulmonary disease (COPD). In the present study we examine NLR, PLR; and other markers, such as eosinophil, MPV, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width (RDW), and C-reactive protein (CRP) in patients with stable and acute exacerbation of COPD. Methods Stable COPD (Group 1, n=140), COPD with acute exacerbation (Group 2, n=110), and healthy controls (Group 3, n=50) were included in the study. Leukocyte, CRP, hemoglobin (HB), RDW, platelet, MPV, PCT, PDW, neutrophil, lymphocyte, eosinophil, NLR, and PLR were analyzed in all groups. Results HB, leukocyte, platelet, neutrophil, eosinophil, MPV, PCT, CRP, NLR, and PLR were significantly higher, while the lymphocyte was lower in Group 1 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while lymphocyte was lower in Group 2 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while HB, platelet, MPV, PCT, and lymphocyte were significantly lower in Group 2 than in Group 1. NLR and PLR increased significantly in patients with bronchiectasis when compared to those without in Group 1. Conclusions Our study results suggest that NLR, PLR and RDW can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

Şahin

Koşar

Aslan

et al. 2019

Journal of Medical Biochemistry

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“…Ozgul et al showed that RDW values were higher in the COPD group than in the controls [ 16 ]. This conclusion was recently supported by a study by Epstein et al, which suggested a number of explanations regarding the link between increased RDW during index exacerbation and higher readmission rates, which may be attributed to a variety of underlying metabolic abnormalities such as increased erythropoietin secretion and unrecognized acute worsening of cardiac function [ 17 ]. To date, the relationship between RDW and the occurrence of PE in COPD patients is a relatively uninvestigated area.…”

Section: Discussionmentioning

confidence: 80%

Predictive Value of Red Blood Cell Distribution Width in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Embolism

Wang

Wan

Qing

et al. 2020

Analytical Cellular Pathology

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Purpose. This study is aimed at investigating the relationship between red cell distribution width (RDW) and chronic obstructive pulmonary disease (COPD) patients with pulmonary embolism (PE). Methods. We conducted a retrospective study enrolling a total of 125 patients from January 2013 to December 2019. The study group consisted of 40 COPD patients with PE, and the control group had 85 COPD patients without PE. Clinical data including demographic characteristics, comorbidities, and results of imaging examinations and laboratory tests were recorded. Blood biomarkers, including red blood cell distribution width standard deviation (RDW-SD), red blood cell distribution width coefficient of variation (RDW-CV), and D-Dimer, were included. Results. RDW-SD and RDW-CV were higher in the COPD patients with the PE group (p<0.001). A higher RDW-SD led to a significantly increased risk of PE than a lower RDW-SD (adjusted odds ratio (OR): 1.188; 95% confidence interval (CI): 1.048-1.348). The area under the curve (AUC) of RDW-SD used for predicting PE was 0.737. Using 44.55 as the cutoff value of RDW-SD, the sensitivity was 80% and the specificity was 64.7%. The prediction accuracy of RDW-SD combined with D-Dimer (AUC=0.897) was higher than that of RDW-SD or D-Dimer alone. The optimal cutoff value of RDW-SD+D-Dimer for predicting PE was 0.266, which generated a sensitivity of 87.5% and specificity of 83.5%. Conclusion. RDW is significantly increased in COPD patients with PE and may thus be useful in predicting the occurrence of PE in patients with COPD.

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“…Tom et al 14 showed that after adjusting for anemia, age, and disease severity (PRISM III), high RDW was an independent risk factor for mechanical ventilation of children (OR 2.6; 95% CI 1.4-4.9; P = 0.004). Danny et al 31 constructed survival curves after adjusting for Charlson comorbidity index and reported that 60-day readmission for AECOPD was higher in patients with high RDW than patients with normal RDW (P = 0.0038). Moreover, results from a retrospective cohort study of MIMIC-III data including 404 eligible ARDS patients suggest that RDW ≥ 14.5% was an independent predictor of 30-day (OR 1.91, 95% CI 1.08, 3.39) and 90-day mortality (OR 2.56, 95% CI 1.50, 4.37) 13 .…”

Section: Discussionmentioning

confidence: 99%

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

Zhang

Wang²,

Wang

et al. 2020

Sci Rep

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The red cell distribution width (RDW) has been reported to be positively correlated with short-term mortality of pulmonary disease in adults. However, it is not clear whether RDW was associated with the long-term prognosis for acute respiratory failure (ARF). Thus, an analysis was conducted to evaluate the association between RDW and 3-year mortality of patients by the Cox regression analysis, generalized additives models, subgroup analysis and Kaplan–Meier analysis. A total of 2999 patients who were first admitted to hospital with ARF were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). The Cox regression analysis showed that the high RDW was associated with 3-year mortality (HR 1.10, 95% CI 1.07, 1.12, P < 0.0001) after adjusting for age, gender, ethnicity and even co-morbid conditions. The ROC curve illustrated the AUC of RDW was 0.651 (95% CI 0.631, 0.670) for prediction of 3-year mortality. Therefore, there is an association between the RDW and survival time of 3 years follow-up, particularly a high RDW on admission was associated with an increased risk of long-term mortality in patients with ARF. RDW may provide an alternative indicator to predict the prognosis and disease progression and more it is easy to get.

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Increased red cell distribution width: A novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease

Abstract: Increased RDW is an independent negative prognostic factor associated with adverse outcomes after hospitalization due to AECOPD.

Cited by 48 publications

References 23 publications

Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

Predictive Value of Red Blood Cell Distribution Width in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Embolism

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

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