Prognostic significance of red cell distribution width in acute mesenteric ischemia.

Abstract

Acute mesenteric ischemia (AMI) is an infrequent, but complicated, life-threatening condition. Given this poor outcome, an estimation of mortality would aid in decision making for physicians, patients and their families. Red cell distribution width (RDW) is reflective of systemic inflammation. RDW is a remarkable prognostic marker for determining the risk of mortality in a wide range of clinical manifestations. The objective of this study was to investigate the association between RDW and mortality in patients with AMI. The medical records of patients who underwent laparotomy with a preoperative diagnosis of AMI were reviewed retrospectively. Primary outcome variable was the hospital mortality rate. Estimating the receiver operating characteristic area under the curve showed that RDW has good discriminative power for mortality (area under the curve = 0.713; 95% confidence interval, 0.584-0.841). With a cut-off value of 14.85 for RDW, mortality could be correctly predicted in approximately 70% of cases. Increased RDW at admission was a predictor of the extent of necrosis and mortality in AMI patients. Further prospective studies are necessary to more accurately assess the importance of RDW in these patients.