SERAP ARGUN BARIŞ, Tuğba ÖNYILMAZ, Esra KUŞLU UÇAR, Tuba ÇİFTÇİ, İlknur BAŞYİĞİT, HAŞİM BOYACI, Füsun YILDIZ

Serum RDW Düzeyinin Pulmoner Tromboemboli Tanılı Hastalarda Klinik Özellikler ve Mortalite Üzerine Etkisi

GİRİŞ ve AMAÇ: Kırmızı kan hücresi dağılımı (RDW), kırmızı kan hücrelerinin heterojenitesini gösteren bir parametredir. Önceki çalışmalarda artmış RDW düzeyinin kardiyovasküler hastalıklarda ve KOAH' ta mortalite ile ilişkili olduğu gösterilmiştir. Çalışmamızın amacı RDW seviyesinin pulmoner tromboemboli (PTE) hastalarına klinik bulgular ve mortalite üzerine etkisinin değerlendirilmesidir. YÖNTEM ve GEREÇLER: Kliniğimizde PTE tanısı ile takip edilen hastaların verileri retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, yatış süreleri, hemogram, troponin ve BNP düzeyleri, arter kan gazı bulguları, radyolojik bulguları, trombolitik tedavi ve YBÜ ihtiyacı ve exitus durumları kaydedildi. BULGULAR: Çalışmaya 71'i kadın (%49,3), 73'ü erkek (%50,7) olmak üzere, yaş ortalaması 58,8 ± 16,3 yıl olan toplam 144 hasta alındı. Ortalama yatış süresi 9,7 ± 5,9 gün idi. RDW değerinin 51 hastada (%35,4) artmış olduğu izlendi. RDW düzeyi normal ve artmış olan gruplar arasında, cinsiyet, troponin, BNP skoru, PA akciğer grafisi, toraks BT bulguları, trombolitik ve YBÜ ihtiyacı açısından anlamlı farklılık izlenmedi. Ancak RDW düzeyi normal ve artmış olan gruplar arasında yatış süresi ve mortalite oranı açısından anlamlı farklılık izlendi (p=0,002 ve p=0,008). EKO'da sağ kalp dilatasyon bulgusu olanlarda olmayanlara göre YBÜ ihtiyacının anlamlı derecede yüksek olduğu izlendi (p=0,012). TARTIŞMA ve SONUÇ: Bu çalışma, artmış RDW seviyelerinin PTE hastalarında uzamış yatış süresi ve mortalite ile ilişkili olabileceğini düşündürmektedir.

The Role of The RDW Level on Characteristics of Hospitalization and Mortality Rates in Patients with Pulmonary Thromboembolism

INTRODUCTION: Red blood cell distribution width (RDW) is a measure of red blood cell size heterogeneity. Recent studies showed that it was related to mortality in cardiovascular disease and COPD. The aim of this study was to evaluate the role the RDW level on characteristics of hospitalization and mortality rates in patients with pulmonary thromboemboli (PTE). METHODS: The records of PTE patients were evaluated retrospectively. The demographic characteristics, duration of the hospitalization, need of thrombolytic therapy or intensive care unit (ICU), radiological and laboratory findings were recorded. RESULTS: There were 71 women (49,3%), 73 men (50,7%), totally 144 patients. The mean age was 58,8 ± 16,3 years. The mean duration of hospitalization was 9,7 ± 5,9 days. RDW level was high in nearly one third of the patients (35,4%). There was no statistically significant difference with respect to the gender, troponin and BNP levels, chest x ray, thorax CT findings and the ratio of thrombolytic therapy or ICU stay between the groups with high and normal RDW level. However, it was found that duration of hospitalization and mortality rates were significantly higher in patients with increased RDW level (p=0,002 and p=0,008). The presence of right ventricle dilatation findings was also related with increased need of ICU (p=0,012). DISCUSSION AND CONCLUSION: This study suggested that increased level of RDW might be related to increased duration of hospitalization and mortality in PTE patients.

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