Association between elevated red blood cell distribution width and long-term mortality in acute pulmonary embolism
Association between elevated red blood cell distribution width and long-term mortality in acute pulmonary embolism
Background/aim: The prognostic value of the red cell distribution width (RDW) as a cost-effective and noninvasive test in acutepulmonary embolism (PE) is still unknown. We aimed to investigate the prognostic value of the admission RDW level in the long-termsurvival of PE patients.Materials and methods: In this registry-based, prospective cohort study, a total of 378 patients (mean age: 60.4 ± 17.11 years, 47.4%female) who presented with acute PE were enrolled. All the clinical data for each patient were obtained from our institutional PEregistry. The follow-up was performed at a median time of 17 months. The primary endpoint was death at follow-up.Results: The mean RDW in study patients was 14.67 ± 2.13. The all-cause mortality rate during the follow-up was 15.6% (n = 59). Afteradjustment for potential confounders, the relationship between RDW and long-term mortality showed a trend of a significant level(hazard ratio: 1.109; 95% CI, 0.998−1.232; P = 0.053). We divided patients into 3 groups based on the European Society of Cardiology’sclassification. As we moved from the low risk to the higher risk categories, the mean RDW increased significantly (P = 0.037).Conclusion: It seems there may be an independent association between RDW at presentation and PE mortality within 17 months.
___
- Celik A, Ozcan IT, Gündes A, Topuz M, Pektas I, Yesil E,
Ayhan S, Kose A, Camsari A, Cin VG. Usefulness of admission
hematologic parameters as diagnostic tools in acute pulmonary
embolism. Kaohsiung J Med Sci 2015; 31: 145-149.
- Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation
between red cell distribution width and clinical outcomes after
acute myocardial infarction. Am J Cardiol 2010; 105: 312-317.
- Ozsu S, Abul Y, Gunaydin S, Orem A, Ozlu T. Prognostic
value of red cell distribution width in patients with pulmonary
embolism. Clin Appl Thromb Hemost 2014; 20: 365-370.
- Sen APHS, Abakay APO, Sezgi APC, Taylan APM, Kaya APH,
Senyigit A. Is a complete blood cell count useful in determining
the prognosis of pulmonary embolism? Wien Klin Wochenschr
2014; 126: 347-354.
- Zorlu A, Bektasoglu G, Guven FMK, Dogan OT, Gucuk E, Ege
MR, Altay H, Cınar Z, Tandogan I, Yilmaz MB. Usefulness of
admission red cell distribution width as a predictor of early
mortality in patients with acute pulmonary embolism. Am J
Cardiol 2012; 109: 128-134.
- Konstantinides S, Torbicki A, Agnelli G, Danchin N, Fitzmaurice
D, Galie N, Gibbs J, Huisman M, Humbert M, Kucher N et al.
ESC Guidelines on the diagnosis and management of acute
pulmonary embolism: The Task Force for the Diagnosis and
Management of Acute Pulmonary Embolism of the European
Society of Cardiology (ESC) Endorsed by the European
Respiratory Society (ERS). Eur Heart J 2014; 35: 3033-3073.
- Heagerty PJ, Zheng Y. Survival model predictive accuracy and
ROC curves. Biometrics 2005; 61: 92-105.
- Patrick J. Package ‘survival ROC’: Time-Dependent ROC
Curve Estimation from Censored Survival Data. R package
version 1.0.3. Vienna, Austria: R Foundation for Statistical
Computing; 2013.
- R Core Team. R: A Language and Environment for Statistical
Computing. Vienna, Austria: R Foundation for Statistical
Computing; 2017.
- Fujita B, Strodthoff D, Fritzenwanger M, Pfeil A, Ferrari M,
Goebel B, Figulla H, Gerdes N, Jung C. Altered red blood cell
distribution width in overweight adolescents and its association
with markers of inflammation. Pediatr Obes 2013; 8: 385-391.
- Chen Z, Tang H, Qayyum R, Schick UM, Nalls MA,
Handsaker R, Li J, Lu Y, Yanek LR, Keating B et al. Genomewide association analysis of red blood cell traits in African
Americans: the COGENT Network. Hum Mol Genet 2013; 22:
2529-2538.
- Yčas JW, Horrow JC, Horne BD. Persistent increase in red cell
size distribution width after acute diseases: a biomarker of
hypoxemia? Clin Chim Acta 2015; 448: 107-117.