Relationship between High Red Cell Distribution Width and Systemic Inflammatory Response Syndrome after Extracorporeal Circulation

Abstract

ObjectiveCardiac surgical operations involving extracorporeal circulation may develop severe inflammatory response. This severe inflammatory response syndrome (SIRS) is usually associated with poor outcome with no predictive marker. Red cell distribution width (RDW) is a routine hematological marker with a role in inflammation. We aim to determine the relationship between RDW and SIRS through our study.MethodsA total of 1250 patients who underwent cardiac surgery with extracorporeal circulation were retrospectively analyzed out of which 26 fell into the SIRS criteria and 26 consecutive control patients were taken. RDW, preoperative clinical data, operative time and postoperative data were compared between SIRS and control groups.ResultsThe demographic profile of the patients was similar. RDW was significantly higher in the SIRS versus control group (15.5±2.0 vs. 13.03±1.90), respectively with P value <0.0001. There was significant mortality in the SIRS group, 20 (76.92%) as compared to 2 (7.6%) in control group with a P value of <0.005. Multiple logistic regression analysis revealed that there was significant association with high RDW and development of SIRS after extracorporeal circulation (OR for RDW levels exceeding 13.5%; 95% CI 1.0-1.2; P<0.05).ConclusionIncreased RDW was significantly associated with increased risk of SIRS after extracorporeal circulation. Thus, RDW can act as a useful tool to predict SIRS in patients undergoing cardiac surgery with extracorporeal circulation. Hence, more aggressive measures can be taken in patients with high RDW to prevent postoperative morbidity and mortality.

The Correlation Between RDW, MPV and Weight Indices After Metabolic Surgery in Patients with Obesity and DM/IGR: Follow-Up Observation at 12 Months

“…One study found that the RDW level was significantly higher in patients with severe autoimmune hepatitis than in those with mild liver inflammation [ 28 ]. Increased RDW was significantly associated with an increased risk of severe inflammatory response syndrome after cardiopulmonary bypass following cardiac surgery [ 29 ]. At 8 weeks after RYGB, the RDW level in obese women was significantly higher than that before RYGB [ 30 ].…”

The association and diagnostic value of red blood cell distribution width in colorectal cancer

“…In this context, RDW is a hematological parameter that reflects heterogeneity in red blood cell size, [5,6] and is reportedly associated with systemic inflammation. [7,8] Given the readily available nature of RDW, it may be more clinically useful than other markers. Furthermore, RDW has been used to distinguish iron deficiency anemia from thalassemia or other hemoglobinopathies, and recent studies have identified elevated RDW in cases of atherosclerosis, inflammatory diseases, and cancers, [22,23] which highlights the potential utility of RDW in CRC diagnosis and prognostication.…”

“…[5,6] Elevated RDW values are associated with several types of anemias, as well as with certain liver disorders and systemic inflammation. [7,8] Recent studies have also indicated that RDW is associated with the development of several cancers, with potential diagnostic and prognostic value for esophageal cancer, multiple myeloma, and hepatocellular carcinoma. [9–11] However, there are scarce and inconsistent data regarding the diagnostic value of RDW in CRC.…”

Association between Red Cell Distribution Width to Platelet Ratio and Disease Activity among Iraqi Patients with Systemic Lupus Erythematosus

“…Another recent study has also concluded that RDW was increased in patients with SLE [12,13]. Due to the effect of inflammatory cytokines, there is a release of premature erythrocytes into the circulation and a resultant increase in RBC distribution width [14]. Moreover, platelets play a major role in SLE pathogenesis and represent a great potential for novel biomarkers and drug development [15].…”