The role of increased red cell distribution width as a negative prognostic marker in patients with COPD

Karampitsakos, Theodoros; Dimakou, Katerina; Papaioannou, Ourania; Chrysikos, Serafeim; Kaponi, Maria; Bouros, Demosthenes; Tzouvelekis, Argyrios; Hillas, Georgios

doi:10.1016/j.pupt.2019.101877

Cited by 25 publications

(28 citation statements)

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“…The role of red cell distribution width (RDW) as a prognostic biomarker in various chronic lung diseases has gained much of attention (1,2). Recently, our study group demonstrated that increased RDW is associated with poor clinical outcomes in chronic lung diseases, including chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis (2,3). RDW reflects the variation of red blood cell volumes and represents a relatively reproducible biomarker, considering the relatively prolonged lifespan of red blood cells.…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, underlying mechanisms of RDW elevation remain to be addressed. It has been suggested that arterial hypoxemia leads to increased erythropoietin secretion and thus to increased RDW through mechanisms that involve regulation of erythrocyte maturation and survival (2). Studies have shown that in patients with Coronavirus Disease 2019 (COVID-19), the severity of hypoxemia is independently associated with in-hospital mortality and can reliably predict admission to the intensive care unit (4).…”

Section: Introductionmentioning

confidence: 99%

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Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

et al. 2020

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Background: There is an amenable need for clinically applicable biomarkers in patients with SARS-CoV-2 infection. Red Cell Distribution Width (RDW) has been recently suggested as a prognostic biomarker for COVID-19.Methods: This was an observational study enrolling patients between February 26 and May 15 2020. We aimed to validate the association of the previously published RDW threshold of 14.5% with markers of disease progression and mortality.Results: A total number of 193 hospitalized patients with COVID-19 were enrolled and analyzed. Median age was 61 years (95% CI: 58–64). Patients with baseline RDW ≥14.5% (n = 41, 19.2%) presented with more progressive disease compared to patients with baseline RDW <14.5% (n = 156, 80.8%) as indicated by significant differences in maximum FiO2% during hospitalization (median: 100, 95% CI: 45.2–100, vs. 35, 95% CI: 31–40, p = 0.0001, respectively). Values of RDW ≥14.5% were also strongly associated with increased risk of mortality (HR: 4.1, 95% CI: 0.88–19.23), (p = 0.02).Conclusion: Our study provides evidence to support reproducibility and validity of a specified cut-off threshold of RDW as biomarker of disease severity and mortality in patients with COVID-19.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

et al. 2020

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“…12 Red blood cell distribution width (RDW) is a widely reported feature of complete blood count (CBC) that represents the erythrocyte size heterogeneity. 13 It can be used to reflect inflammation, red blood cell damage and disorders in red blood cell formation. Inflammatory responses and oxidative stress caused by COPD may elevate RDW.…”

Section: Introductionmentioning

confidence: 99%

Mean platelet volume combined red cell distribution width as biomarker of chronic obstructive pulmonary disease with pulmonary heart disease

Bai

Tao

2020

Clinical Respiratory J

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Background and objective Platelet activation, inflammatory reactions and oxidative stress are common pathogenesis of chronic obstructive pulmonary disease (COPD) with pulmonary heart disease (PHD). Mean platelet volume (MPV) and red blood cell distribution width (RDW) form part of the pathomechanisms of these conditions. Here, we investigated whether MPV and RDW can be biomarkers of PHD occurring secondary to COPD. Materials and methods This was a retrospective study on 229 participants with COPD. Among them, 69 had PHD. Complete blood count (CBC), blood gas analysis, pulmonary function tests and echocardiography were analyzed. Results MPV and RDW‐standard deviation (RDW‐SD) were significantly higher in patients with PHD than in patients without PHD (P ≤ 0.001). MPV and RDW‐SD were positively correlated with pulmonary artery pressure (PAP) and the size of the right ventricle (P ≤ 0.05). Multivariate regression analysis showed that the risk of PHD increased 3‐fold per unit rise in MPV (OR = 2.901, P ≤ 0.001). We observed that the risk of PHD increased 1.5 times per unit rise in RDW‐SD (OR = 1.371, P ≤ 0.001).The AUC of ROC curve for the combined MPV and RDW‐SD in predicting PHD among COPD patients was 0.900 (95％CI: 0.846‐0．954, P ≤ 0.001), with a sensitivity of 76.8% and a specificity of 99.4%. Conclusions Both MPV and RDW‐SD were significantly elevated and correlated with disease severity in COPD patients with PHD. A combination of these two parameters presents an effective biomarker of PHD.

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“…An increase in RDW may also play a role in the early diagnosis of intermittent hypoxia. 17 A high RDW value may be a more reliable marker of tissue hypoxia. 18 Previous studies demonstrated that hypoxia may contribute to an increase in cardiac load and risk for cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Increase of Red Cell Distribution Width Predicts Increased Risk of 30-Day Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zhu¹,

Dai²,

Wan³

et al. 2021

COPD

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Purpose Studies have demonstrated that red blood cell distribution width (RDW) is closely associated with the prognosis of patients with chronic obstructive pulmonary disease (COPD). In addition, the dynamic changes in RDW appear to play an important role. Thus, we aimed to investigate the relationship between dynamic changes in RDW and 30-day all-cause readmission of patients with acute exacerbation of COPD (AECOPD). Methods In this retrospective cohort study, we enrolled patients with AECOPD hospitalized in the Department of Respiratory Medicine in Liyuan Hospital (Wuhan China), a tertiary, university-affiliated, public hospital. Patients with AECOPD were divided into three groups based on their RDW values after the first and fourth days of admission. The normal range for RDW is 10–15%. Patients with normal RDW values were included in the normal group. Patients with an RDW value >15% on the first day, which subsequently decreased by >2% on the fourth day was included in the decreased group. The increased group was comprised of patients with an RDW value >15% on the first day which continued to increase, or those with a normal RDW value on the first day which increased >15% on the fourth day. Results A total of 239 patients (age: 72 years [range: 64–81 years]; male: n=199 [83.3%]) were included. There were 108, 72, and 59 patients in the RDW normal, decreased, and increased groups, respectively; the 30-day all-cause readmission rate was 9.3%, 9.7%, 27.1%, respectively; (p=0.003), being noticeably higher in the RDW increased group. Dynamic increase of RDW (OR:3.45, 95% CI: 1.39–8.58, p= 0.008) was independently correlated with 30-day all-cause readmission of patients with AECOPD. Conclusion The dynamic increase of RDW is an independent prognostic factor of 30-day all-cause readmission of patients with AECOPD.

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The role of increased red cell distribution width as a negative prognostic marker in patients with COPD

Cited by 25 publications

References 28 publications

Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

Mean platelet volume combined red cell distribution width as biomarker of chronic obstructive pulmonary disease with pulmonary heart disease

Dynamic Increase of Red Cell Distribution Width Predicts Increased Risk of 30-Day Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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