Mean Red Cell Distribution Width Research Articles

Red cell distribution width as a predictor of cardiovascular events in high-risk patients with statin intolerance: post-hoc analysis of the CLEAR Outcomes trial

Abstract Background Despite optimal lipid-lowering therapy there is up to 70% residual risk of recurrent atherosclerotic cardiovascular disease (ASCVD) events, motivating further testing of alternative risk factors and disease pathways. Red cell distribution width (RDW) is a simple and reproducible marker of heterogeneity of cell size in the peripheral blood. High RDW is associated with an increased risk of ASCVD and death, independent of established risk factors. Recent data suggest no significant impact of PCSK9 inhibitors on hsCRP or RDW. In CLEAR Outcomes, baseline hsCRP predicted risk for future cardiovascular (CV) events and death more strongly than elevated LDL-C. It has been shown that bempedoic acid (BA) reduces hsCRP, but its effects on RDW are unknown. Purpose To analyze the effect of BA on a 4-component composite of incident myocardial infarction, stroke, coronary revascularization, or cardiovascular death (MACE-4) and for CV death by baseline RDW, and to confirm the association of increased RDW with elevated risk of MACE. Methods A total of 13,970 individuals with statin intolerance, with or at high risk for ASCVD, were randomized in the multinational CLEAR Outcomes trial with a median follow up of 3.4 years. Compared to placebo, BA reduced mean LDL-C by 21% and median hsCRP by 22% at 6 months. Quartiles of increasing baseline RDW were assessed as predictors of future adverse events after adjustment for traditional risk factors, hsCRP, and randomized treatment assignment. Results Compared to placebo, BA reduced mean RDW by 0.28% at 6 months and 0.13% at 36 months (p<0.0001). There was a weak positive correlation between hsCRP and RDW at baseline (Figure 1). In the placebo group, higher baseline RDW was associated with an increase in the likelihood of MACE-4 and CV death, and the hazard ratios (HR) associated with a 1% increase in RDW after adjusting for covariates and hsCRP were 1.06 (95% CI 1.02-1.11) and 1.22 (1.15-1.29), respectively. When grouped by quartiles of baseline RDW, compared with a reference group with lowest RDW (<13.7%), there was a notable increase in the risk of MACE-4 and CV death among the higher quartiles in the placebo group (Table 1). Those in the 4th quartile demonstrated a 3-fold increase in the risk of CV death (HR, 3.03, 2.00-4.60). The adjusted HRs (95% CI) for BA vs placebo for MACE-4 were generally lower in individuals with elevated baseline RDW than in those in the first quartile [Q1: RDW≤13.7%; 0.96 (0.79-1.17), Q2: RDW 13.7%-14.4%; 0.81 (0.67-0.97), Q3: RDW 14.4%-15.2%; 0.90 (0.75-1.09), and Q4: RDW>15.2%; 0.84 (0.7-1.01)]. Conclusions In a large randomized controlled clinical trial setting, we confirmed an association between elevated RDW and MACE-4. Compared with placebo, BA demonstrated efficacy in reducing CV risk in patients with moderately increased RDW.Figure 1.Correlation of hsCRP and RDWTable 1.Risk of Outcome by RDW Quartile

Effect of Smoking on Red Blood Cell Parameters: A Cross-sectional Study in a Divisional City of Bangladesh

Background: Several metabolic and biochemical processes, hormone secretion, and the haematological system are all affected by smoking. Numerous studies have found that smoking is associated with higher levels of haemoglobin concentration (Hb%), total red blood cell count (RBC), and red cell distribution width (RDW). Objectives: To study the RBC parameters in healthy male smokers and non-smokers among adults. Methodology: This research was carried out in the Department of Physiology of Sylhet MAG Osmani Medical College, from July, 2021 to June, 2022. A total of 200 participants were included with healthy adult smokers and age-matched healthy adult non-smokers. History and physical examinations were used to evaluate each individual. We measured height and weight, and calculated body mass index of the subjects. Calculations were made on cigarette smoking intensity and duration. Blood was collected to determine RBC parameters, such as total RBC count, haemoglobin level, haematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and red cell distribution width (RDW) by using Sysmex 500i automatic haematology analyzer (Japan). Results: Among the 200 participants, 100 were adult smokers and another 100 age-matched healthy adult non-smokers. The RBC indices were significantly elevated in smokers compared to non-smokers group: mean haemoglobin concentration (g/dl)+ standard deviation (SD) were 14.17 ± 2.13 versus 13.27 ± 1.39 respectively with p<0.001, mean haematocrit (HCT) (percent)+ SD were 41.60 ± 6.88 versus 39.13 ± 5.46 respectively with p=0.005, mean corpuscular volume (MCV) (fl) + SD 91.13 ± 8.86 versus 88.33 ± 5.58 respectively with p=0.033, mean corpuscular hemoglobin (MCH) (pg) + SD 31.16 ± 3.26 versus 30.05 ± 3.0 respectively with p=0.016 and mean red cell distribution width (RDW) (percent)+ SD 14.74 ± 1.63 versus 14.00 ± 1.57 respectively with p=0.001. However, RBC count (×106/μl) (4.60 ± 0.80 versus 4.46 ± 0.60; p=0.143) and mean corpuscular haemoglobin concentration (MCHC) (g/dl) (34.23 ± 2.11 versus 34.11 ± 2.32; p=0.707) did not differ significantly between smoker and non-smoker groups. There was no statistical difference between mild, moderate, and severe smokers, according to the study's variables. Conclusion: MCV, MCH, RDW, haematocrit, and haemoglobin concentration were all significantly higher in smokers. Journal of Monno Medical College December, 2023; 9 (2):41-46

Evaluating The Diagnostic Value Of Red Cell Distribution Width (RDW) In Identifying Iron Deficiency Anemia: A Retrospective Analysis

Background: Iron Deficiency Anemia (IDA) is the most prevalent form of anemia globally, with a significant impact on public health, especially in low-resource settings like Bangladesh. Accurate and early diagnosis of IDA is essential for effective treatment. Red Cell Distribution Width (RDW) has emerged as a promising, accessible diagnostic tool for IDA, yet its utility remains underexplored in this context. Methods: This retrospective cross-sectional study, conducted between July 2022 and July 2024 at Addin Barrister Rafique-ul Huq Hospital in Bangladesh, included 106 patients diagnosed with microcytic hypochromic anemia. Key hematological parameters, including hemoglobin, RBC count, MCV, and RDW, were analyzed. Correlation analyses were performed to assess the relationships between RDW and other parameters such as hemoglobin, MCV, RBC count, and Erythrocyte Sedimentation Rate (ESR). Results: RDW was elevated (>14.5%) in 92.45% of the participants, with a mean RDW of 17.59±3.33%. Significant negative correlations were observed between RDW and hemoglobin (r = -0.435, p < 0.001) and between RDW and MCV (r = -0.664, p < 0.001). RDW showed positive correlations with RBC count (r = 0.315, p = 0.001) and ESR (r = 0.225, p = 0.041). The study confirmed RDW’s strong diagnostic value in distinguishing IDA, particularly in resource-constrained settings. Conclusion: RDW, combined with other hematological parameters, is a sensitive and reliable marker for diagnosing IDA. Its incorporation into routine diagnostic protocols could significantly enhance IDA detection and management in low-resource settings like Bangladesh.

Retrospective evaluation of patients with vitamin B12 deficiency in the pediatrics outpatient clinic

Background/Aim: This study examines patients diagnosed with vitamin B12 deficiency in our department. Although rare, vitamin B12 deficiency is one of the causes of megaloblastic anemia, which can lead to negative outcomes in patients. We aim to promote earlier diagnosis to protect patients from these negative effects. Therefore, this study will contribute to raising awareness in the literature. Methods: Retrospectively, we included a total of 127 outpatient children, aged 0–18 years (0–215 months), who were diagnosed and treated for vitamin B12 deficiency at the Bagcilar Training and Research Hospital Child Health and Disease Clinic between October 2014 and February 2015. Results: Among the patients, 67 (53%) with vitamin B12 deficiency were female, while 60 (47%) were male, indicating a higher occurrence in girls. Vitamin B12 deficiency was most commonly observed in the age groups of 0-2 years and 12-17 years (adolescents). The mean vitamin B12 level was 168.1 (34.1) pg/mL, the mean hemoglobin level was 12 (1.9) g/dL, and the mean MCV (mean corpuscular volume) was 78.4 (8.1) fl. Anemia was observed in 38% of the patients, bicytopenia in 4%, neutropenia in 6%, thrombocytopenia in 9%, pancytopenia in 3%, and macrocytosis in 2%. Non-iron-deficient patients showed no difference in mean hemoglobin and RDW (red cell distribution width) when compared to iron-deficient patients. However, their B12 levels were lower. The prevalence of iron deficiency did not differ between girls and boys. Comparing patients with vitamin B12 levels lower than 150 pg/mL to those with higher levels, there were no significant differences in average Hb, MCV, and RDW. Conclusion: It should be noted that macrocytic anemia is not exclusive to vitamin B12 deficiency. Vitamin B12 deficiency can manifest as normocytic anemia and should not be overlooked in biochemical assessments. It is recommended to conduct nationwide and regional prevalence studies to evaluate vitamin B12 deficiency as a public health issue and to develop new solutions accordingly.

Neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume as practical markers in febrile seizure classification.

To examine the neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume in patients with febrile seizure and to determine their role in febrile seizure classification. This was a retrospective hospital-based study conducted among patients aged 5 to 72 months admitted with febrile seizure. Children who had febrile seizures due to upper respiratory tract infection were included in the study. The children were divided into two groups: simple febrile seizures and complex febrile seizures. Patients with a history of febrile status epilepticus, previous convulsions, use of antiepileptic or other chronic drugs, foci of infection other than the upper respiratory tract infection, abnormal biochemical parameters, and chronic mental or physical disease were excluded from the study. Clinical and laboratory findings of the patients were obtained from digital medical records. The records of 112 febrile seizure patients were reviewed, and 89 were grouped as simple and 23 as complex febrile seizures. Although there was no statistically significant difference between the two groups in terms of the mean red cell distribution width values (p=0.703), neutrophil-lymphocyte ratio and mean platelet volume were significantly higher in patients with complex febrile seizures (p=0.034, p=0.037; respectively). This study showed that neutrophil-lymphocyte ratio and mean platelet volume could be practical and inexpensive clinical markers for febrile seizure classification. A similar result could not be reached for red cell distribution width in this study. These findings should be supported by multicenter studies with large samples.

Complete Blood Cell Count-Derived Inflammation Biomarkers in Patients with Xanthelasma Palpebrarum.

Xanthelasma palpebrarum (XP) is the most common type of cutaneous xanthoma, characterized by yellowish cutaneous plaques commonly located near the medial canthus of the eyelid. Although dyslipidemia significantly contributes to its development, inflammation is also believed to be another element in the pathogenesis, especially in normolipidemic patients. Recently, cell counts derived from complete blood counts have been identified as indicators of systemic inflammatory conditions and have also been under discussion concerning their relevance to ocular diseases. This study aimed to assess inflammation indices derived from complete blood cell counts (CBC) in XP patients with normal lipid levels. Patients who had been referred to the oculoplasty department with the diagnosis of XP between January 2020 and January 2023 and age-matched control subjects were retrospectively reviewed. Patients who had abnormal lipid profiles and systemic diseases such as diabetes mellitus, hypertension, malignancy, cardiovascular diseases, systemic infections, and inflammatory diseases were not included in the study. CBC parameters were analyzed and compared between the groups. The study comprised 27 normolipidemic patients with XP and 27 age-matched healthy individuals as the control group. There were no statistically significant differences between the two groups in terms of age (p=0.143). The mean hemoglobin, neutrophil, monocyte, lymphocyte, platelet, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and aggregate index of systemic inflammation values were higher in the patient group, but the differences were not statistically significant (p>0.05). The mean red cell distribution width and platelet-to-lymphocyte ratio appeared to be lower in the patient group compared to the control group; however, no significant differences were observed between the two groups (p=0.272, p=0.387, respectively). This study might offer insights into the pathogenesis of XP, yet numerous questions remain unanswered, awaiting further investigation in future studies.

Understanding the Etiopathogenesis of Non-Arteritic Anterior Ischemic Optic Neuropathy with Laboratory Findings.

The role of inflammation and hemostasis in non-arteritic anterior ischemic optic neuropathy (NAION) was investigated by examining related blood tests. The predictive values of these laboratory indicators and their effects on prognosis were reviewed. In this study, 48 patients diagnosed with NAION and 50 healthy volunteers were included. All subjects underwent full ophthalmological examination. All patients were treated with oral corticosteroids (methylprednisolone 1 mg/kg/day) for 15 days after that corticosteroid medication was reduced and stopped. Each patient was monitored at least for 12 months. The mean platelet volume (MPV), platelet distribution width (PDW), neutrophil/lymphocyte ratio (NLR), and red cell distribution width (RDW) values were recorded. These findings were compared with control group. The mean MPV, RDW, and NLR values were significantly higher in NAION group (respectively, p<0.001, p=0.006, and p<0.001). There was no statistically significant difference between group 1 and group 2 in PDW values, but the mean PDW value was higher in the patient group compared to the control group (p=0.435). Based on the receiver operating characteristic (ROC) curve, the NLR had the strongest predictive value. This was followed by MPV, RDW, and PDW with lower diagnostic predictive values. MPV, NLR, and RDW were found to be elevated and have diagnostic predictive values in NAION patients. Easily accessible and simple laboratory methods could help us show systemic inflammation and ischemic events in NAION patients. As a result, inflammatory reactions besides ischemic changes may play a role in the etiopathogenesis of NAION. These biomarkers can be evaluated to ensure that patients with risk factors for the development of NAION.

Association of Red Cell Distribution Width with Thrombus Burden in Patients of ST Elevation Myocardial Infarction Undergoing Primary PCI

Objective: To study the association of Red Cell Distribution Width (RDW) with thrombus burden in patients of ST Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI). Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi, Pakistan, from Aug 2022 to Dec 2022. Methodology: Using non-probability consecutive sampling, three hundred and sixty-nine (n=369) patients were included in the study. RDW values were obtained from complete blood count sent at presentation in emergency department. Thrombolysis in Myocardial Infarction (TIMI) thrombus grading was used to determine the angiographic thrombus burden. For quantitative variables, means and standard deviations were calculated, while frequencies and percentages were calculated for qualitative variables. Receiver Operating Characteristic (ROC) curve for RDW values for predicting thrombus burden was plotted. Correlation between RDW with thrombus burden was established. Eta, Chi-square and independent samples t-test was used to determine p-value. Results: The study included 369 STEMI patients, out of which 287(77.8%) were males and 82(22.2%) were females. 203(55.0%)patients had high thrombus burden while 166(45.0%) patients had low thrombus burden. Patients in the high RDW groupmore frequently had ventricular arrhythmias, and heart blocks. Mean RDW was 13.57±0.71 in low thrombus burden groupwhile it was 14.67±1.21 in high thrombus burden group. Area under the curve derived from ROC curve for RDW forpredicting high thrombus burden was 0.79(CI=0.74-0.83, p&lt;0.001) Conclusion: The study demonstrates that high RDW is a sensitive and specific predictor of high angiographic thrombus bur..........

Red Cell Distribution Width and Neutrophil Lymphocyte Ratio as A New Biomarker for Severity in Rheumatoid Arthritis and its Comparison with DAS 28 ESR Score

Objective: To determine the association of red cell distribution width (RDW)and neutrophil-lymphocyte ratio (NLR)with the severity of rheumatoid arthritis by using DAS28 ESR. Additionally, toxic granulations were assessed as an indicator of disease severity. Study Design: Cross-sectional study. Place and Duration of Study: Rheumatology Outpatient Department, Federal Government Polyclinic Hospital, IslamabadPakistan, from Dec 2020 to Jun 2021. Methodology: Two hundred ninety rheumatoid arthritis patients were included. DAS 28 ESR was calculated using the DAS 28 ESR calculator, and RDW and NLR were extracted from the complete blood picture and peripheral smears. Results: There were 238(82.1%) female and 52 17.9%) male study participants. The mean age of patients was 45.2±12.8. The mean RDW, NLR and DAS 28 ESR in the study were 45.67±4.25, 2.93±1.35 and 4.29±1.25, respectively. Toxic granulations on peripheral smears were also found in 188(64.8%) patients. A significant positive association was found using the Spearman rho correlation between the DAS28 ESR score, RDW and NLR (p-value 0.024 and &lt;0.001, respectively). Conclusion: Red cell distribution width and neutrophil-lymphocyte ratio, along with toxic granulations, can be used as reliable biomarkers of inflammation in rheumatoid arthritis patients. Values higher than the reference range indicate higher disease severity.

Red Cell Distribution Width, Mean Platelet Volume, and Neutrophil/Lymphocyte Ratio in Patients With Irritable Bowel Syndrome.

Introduction Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by persistent abdominal pain and variable bowel patterns, impacting individuals' quality of life. Despite its functional nature, recent research has indicated the role of inflammatory processes in IBS development. This study aims to investigate the potential diagnostic value of routine blood parameters and their relationship with IBS. Methods In this retrospective analysis, patients diagnosed with IBS based on the ROME IV criteria were identified from the outpatient clinic of Hitit University Erol Olçok Teaching and Research Hospital between January 1, 2023, and May 1, 2023. Exclusion criteria encompassed specific medical conditions, psychiatric disorders, and organic bowel pathologies. A cohort of 100 IBS patients and 100 healthy controls were included for comparison. Comprehensive blood data, including neutrophil count, lymphocyte count, hemoglobin level, red cell distribution width (RDW), mean corpuscular volume (MCV), mean platelet volume (MPV), and platelet count, were collected. Statistical analyses were conducted using SPSS for Windows version 26.0 (IBM Corp., Armonk, NY). Descriptive statistics, Pearson's or Spearman's correlation coefficients, Mann-Whitney U test, and Chi-square test were used to analyze data. Results The study cohort consisted of 70 men (35%) and 130 women (65%). The average age was 51.65 ± 14.64 years (52 years). The mean neutrophil count was 4.6 ± 1.5 (4.29) in the control group and 4.7 ± 2.03 (4.12) in the IBS group. The mean lymphocyte count was 2.3 ± 0.86 (2.21) in the control group and 2.3 ± 0.82 (2.23) in the IBS group, indicating no statistically significant difference (p = 0.732). The mean RDW was measured as 13.62 ± 1.07 (13.4) in the control group and 13.68 ± 1.18 (13.55) in the IBS group, again demonstrating no significant difference (p = 0.915). Mean MCV and MPV values showed no substantial variation between the control and IBS groups (p = 0.649 and p = 0.406, respectively). Conclusion While this study did not yield statistically robust outcomes, it underscores the potential of utilizing neutrophil-to-lymphocyte ratio (NLR), RDW, and MPV as adjunctive diagnostic markers for IBS. These routine and cost-effective parameters could enhance the diagnostic process, especially in cases with suspected IBS. Continued research is essential to unravel their complete diagnostic potential and clinical applicability.

Red cell distribution width-a potential prognostic indicator for colorectal cancer patients after radical resection in China.

Red cell distribution width (RDW) can signal poor prognosis in inflammatory medical conditions. The purpose of the study was to investigate the relationship between preoperative RDW and colorectal cancer (CRC) in a large cohort of patients. A total of 6,224 CRC patients who underwent radical resection at the Fudan University Shanghai Cancer Center were evaluated retrospectively. The prognostic significance of RDW for overall survival (OS) and disease-free survival (DFS) was analyzed using Cox proportional hazards models and Kaplan-Meier method. Propensity score matching (PSM) was used based on survival confounding factors. The mean age of the study participants was 59.5±12.0 years and the study cohort was 44% female. The overall median and mean RDW values were 13.3% and 14.0%, respectively. Patients were stratified into three groups based on their RDW value (≤13.3%, 13.4-14.0%, and >14.0%). OS and DFS were shown to significantly deteriorate with increasing RDW category. In the PSM population, OS and DFS were significantly lower in the high RDW group compared with matched controls. However, the differences vanished in the comparisons between the middle RDW group and the control group. Our findings demonstrate that preoperative RDW may represent a simple and powerful prognostic factor for CRC patients after radical resection. Integrating RDW into clinical practice may better inform the prognosis and optimize therapeutic approaches for patients with CRC.

The predictive value of complete blood count-derived indices for major adverse cardiovascular events in MINOCA patients at 5-year follow-up

Introduction: The authors analysed the potential of red blood cell and platelet indices such as red cell distribution width (RDW), mean corpuscular volume (MCV), and mean platelet volume (MPV) as predicting factors in myocardial infarction with non-obstructive coronary arteries (MINOCA) patients of 5-year outcomes. Material and methods: Between 2010–2015 were identified 112 patients who had final MINOCA diagnosis and available laboratory findings. The primary endpoint was the 5-year major adverse cardiovascular events rate, defined as cardiac death, myocardial infarction, or hospitalization due to angina. Results: Only RDW had a significant impact on long-term outcomes. 93 (83%) patients had RDW ≤ 14.5 (group 1), and 19 (17%) patients had RDW &gt; 14.5 (group 2). The mean RDW value was 13.58 ± 1.11%. In group 1 and group 2, mean RDW values were 13.18 ± 0.55%, and 15.54 ± 1.06% (p &lt; 0.001), respectively. Patients with abnormal RDW values (group 2) characterized lower value of left ventricular eject fraction (60 ± 8% vs. 53 ± 13%, p = 0.024), and higher NT-proBNP values (3,170 ± 5,285 pg/mL vs. 6,200 ± 4,223 pg/mL, p = 0.013) as well as troponin levels (501–2500 ng/mL: 31% vs. 53%, p = 0.02). A statistically significant difference was observed only for all-cause death. All-cause death rates for no RDW ≤ 14.5% vs. RDW &gt; 14.5% were 2.2% vs. 21.1% (HR 5.09, 95% CI 1.03–25.2, p = 0.046), respectively. Conclusions: RDW was significantly associated with the increased risk of all-cause mortality in MINOCA patients at 5 years.

Red blood cell distribution width as a potential inflammatory marker in pediatric osteomyelitis

Background Red cell distribution width (RDW) has been used in the differential diagnosis of anemia and revealed to be a potential marker of inflammation. Method We conducted a retrospective study of acute-phase reactant changes in correlation with RDW among pediatric patients with osteomyelitis. Results We identified 82 patients whose mean RDW increased on average by 1% during antibiotic therapy (mean 13.9% on admission, 95% CI 13.4–14.3, and 14.9% at the end of antibiotic therapy, 95% CI 14.5–15.4). Overall, the RDW was weakly correlated with absolute neutrophil count (r = −0.21, P = 0.001), erythrocyte sedimentation rate (r = −0.17, P = 0.007), and C-reactive protein (r = −0.21, P = 0.001). The generalized estimating equation model showed a weak negative correlation between RDW and C-reactive protein during the therapy duration (B= −0.03, P = 0.008). Conclusions The mild increase in RDW, and its weak negative correlation with other acute-phase reactants during the study course, limits its utility as a therapy response marker in pediatric osteomyelitis.

Red cell distribution width and neutrophil-lymphocyte ratio as inflammatory markers in patients with rheumatoid arthritis.

The aim was to study the red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) as inflammatory markers and their correlation with clinical disease activity parameters in patients with rheumatoid arthritis (RA). This observational cross-sectional study included 100 randomly selected patients with RA. Disease Activity Score with 28-joint counts and erythrocyte sedimentation rate (DAS28-ESR) was taken as a marker of disease activity. The diagnostic value of NLR and RDW in RA was assessed. The majority (51%) of cases showed mild disease activity. The mean NLR in cases was 3.88 ±2.59. Mean RDW was 16.25 ±2.49%. Neutrophil-lymphocyte ratio significantly correlated with ESR (p = 0.026), severity of pain (p = 0.013), osteoporosis (p = 0.014) and radiographic joint erosions (p = 0.048), but not with DAS28-ESR (p > 0.05) and C-reactive protein (CRP) (p > 0.05). Red cell distribution width showed a significant correlation only with NLR (p = 0.009). The positive predictive values of NLR and RDW for disease activity were 93.3% and 90% and the negative predictive values were 20% and 16.7% respectively. For NLR, the area under the curve (AUC) was 0.78 (p = 0.001) and at a cut-off value of 1.63, the diagnostic sensitivity was 97.7% and specificity 50%. For RDW, the AUC was 0.43 (p = 0.40) and at a cut-off value of 14.52, the diagnostic sensitivity was 70.5% and specificity 41.7%. The sensitivity and specificity of NLR were higher than those of RDW. A significant difference was seen between the AUC of NLR and RDW (p = 0.02). Neutrophil-lymphocyte ratio is a valuable inflammatory marker in patients with RA, but RDW is not useful in this regard.

Red Cell Distribution Width and the Severity of Acute Exacerbration of Chronic Obstructive Pulmonary Disease - A Hospital Based Case Control Study

Abstract Background and Objective: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the most common diseases in patients with having frequent hospitalization. The aim of this study is to find whether there is any relationship between red cell distribution width (RDW) with mortality in acute exacerbation of COPD. Materials and Methods: The hospital-based case–control study is conducted on hospitalized 50 patients with the diagnosis of acute exacerbation of COPD and 50 patients with stable period of COPD. Results: This was a hospital-based case–control study in the age group of above 30 years in hospitalized 50 patients with a primary and definite diagnosis of acute exacerbation of COPD and 50 participants in stable period of COPD conducted among admitted in the department of medicine. Maximum patients in both groups were found in the &gt;60 years age group. The mean age in acute exacerbations of COPD group was 64.62 ± 8.24 years and in stable COPD were 63.22 ± 9.18 years. Both groups were comparable. Maximum patients in both groups were male. The mean RDW significantly higher in acute exacerbation of COPD (17.60% ±5.70%) as compared to stable COPD patients (13.80% ±3.33%). The difference in both groups was found statistically significant. The mean corpuscular volume was significantly lower in acute exacerbation of COPD (82.04 ± 1.49) as compared to stable COPD patients (86.50 ± 1.87). The difference in both groups was found statistically significant. RDW was significantly higher in those patients who were died (19.50% ±0.70%) as compared to survived patients (17.52% ±5.61%). The difference in both groups was found to be statistically significant. 4.00% hospital mortality in acute exacerbation of COPD group compared with stable COPD patients. Conclusion: We have concluded that the mean RDW on the day of presenting the illness was significantly higher in acute exacerbation of COPD as compared to stable COPD. Those patients who had a high RDW during admission were associated with poor prognoses.

Red Cell Distribution Width and Platelet Indices in Women with Pre-eclampsia: A Cross-sectional Study

Introduction: To determine the prognosis and fetomaternal outcome in eclampsia and pre-eclampsia, a simple and costeffective approach is to assess the Red cell Distribution Width (RDW) and platelet count. RDW, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and platelet markers such as Mean Platelet Volume (MPV) have been the subject of research. Aim: To compare the variation of RDW, NLR, PLR, and platelet indices between women with pre-eclampsia and gestational age-matched healthy controls. Materials and Methods: A cross-sectional study was conducted among 208 pregnant women (104 with pre-eclampsia and 104 controls) at the Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, from January 2020 to June 2021. RDW, NLR, PLR, and platelet indices were analysed after obtaining detailed history, conducting clinical examinations, and relevant investigations. An Independent t-test was used as a test of significance to identify the mean difference between the two quantitative variables. Results: The RDW among cases was 17.05±4.01, whereas among controls, it was 15.09±1.86. The mean age of subjects among case group was 25.72±4.741 years, while in the control group it was 23.25±3.803 years. There was a significant difference in mean Red cell Distribution Width- Coefficient of Variation (RDW-CV) between the two groups. The MPV among cases was 9.86±1.14, while among controls, it was 8.92±1.40 (p-value=0.001). The PDW among cases was 11.30±2.20, and among controls, it was 12.72±3.50. The mean NLR among cases was 5.92±4.94, whereas among controls, it was 4.59±2.22. There was a significant difference in mean platelet count, MPV, PDW, and NLR between the two groups. Conclusion: According to the findings of the current study, RDW, NLR, and MPV were all shown to be higher in women with pre-eclampsia. Additionally, pre-eclamptic women consistently exhibited decreased PDW and platelet counts.

Neonatal hiperbilirubineminin prediktörü olarak umblikal kord kanı kırmızı hücre dağılım genişliği

Aim: Early postnatal discharge of newborns leads to the risk of hospital readmission, mostly due to neonatal hyperbilirubinemia. Therefore, early identification of newborns at high risk of hyperbilirubinemia is important. In this study, we aimed to evaluate whether cord blood red cell distribution width (RDW) levels could be used to identify newborns at high risk of developing hyperbilirubinemia.&#x0D; Material and methods: The data of all term infants who were born in our hospital between January and June 2017 whose cord blood samples were examined were reviewed retrospectively. Cord blood RDW, cord blood bilirubin, newborn/mother’s blood groups and direct Coombs’test (DCT) results were analyzed. &#x0D; Results: A total 175 newborns were included. Phototherapy was required 58 newborns in the first 48 hours postnatally. The mean cord blood RDW levels among newborns with hyperbilirubinemia was significantly higher compared to controls (18±1.6 vs. 16.4±1.0, p

The evaluation of red cell distribution width in type 2 diabetic patients with acute ST- segment elevation myocardial infarction in Erbil city: a cross sectional study

Background: The relationship of high red cell distribution width (RDW) with many hematological and angiographic characteristics in type 2 diabetic patients with acute ST-segment elevation myocardial infarction (STEMI) is still a matter of debate.&#x0D; Objective: To evaluate the relationship of high RDW with multiple hematological and angiographic characteristics in type 2 diabetic patients with acute STEMI.&#x0D; Patients and Methods: In this cross-sectional study, one hundred patients with acute STEMI who underwent coronary angiography were enrolled. The patients were divided into two groups according to the presence of type 2 diabetes mellitus (T2DM); group I, diabetic patients and group II, non-diabetic patients. Further division was made to group I patients based on how high or low RDW level was; subgroup A patients with high RDW level, and subgroup B patients with low RDW level. The groups were evaluated and compared regarding baseline demographic, laboratory and angiographic characteristics.&#x0D; Results: The mean RDW was higher (P=0.04) in group I compared to group II. The mean values of white blood cell (WBC) , RDW, CK-MB, Troponin T high sensitive (hs) , and HbA1C levels were significantly higher in subgroup A compared to subgroup B (P=0.007, 0.003, 0.03 and &lt; 0.001, respectively). Subgroup A patients have significantly more extension of coronary diseases than subgroup B (P=0.001). A positive correlation was detected between RDW and WBC, CK-MB, Troponin T hs, HbA1C as well as number of diseased vessels in diabetic patients (0.76, 0.4, 0.98 and 0.79, respectively).&#x0D; Conclusion: Diabetic patients with acute STEMI had higher levels of RDW than non-diabetics and higher levels were positively correlated with inflammatory and poor outcome cardiovascular markers as well as multiple vessel diseases involvement. It was also correlated with poor glycemic control represented by high HbA1C.

The evaluation of red cell distribution width in type 2 diabetic patients with acute ST- segment elevation myocardial infarction in Erbil city: a cross sectional study

Background: The relationship of high red cell distribution width (RDW) with many hematological and angiographic characteristics in type 2 diabetic patients with acute ST-segment elevation myocardial infarction (STEMI) is still a matter of debate. Objective: To evaluate the relationship of high RDW with multiple hematological and angiographic characteristics in type 2 diabetic patients with acute STEMI. Patients and Methods: In this cross-sectional study, one hundred patients with acute STEMI who underwent coronary angiography were enrolled. The patients were divided into two groups according to the presence of type 2 diabetes mellitus (T2DM); group I, diabetic patients and group II, non-diabetic patients. Further division was made to group I patients based on how high or low RDW level was; subgroup A patients with high RDW level, and subgroup B patients with low RDW level. The groups were evaluated and compared regarding baseline demographic, laboratory and angiographic characteristics. Results: The mean RDW was higher (P=0.04) in group I compared to group II. The mean values of white blood cell (WBC) , RDW, CK-MB, Troponin T high sensitive (hs) , and HbA1C levels were significantly higher in subgroup A compared to subgroup B (P=0.007, 0.003, 0.03 and &lt; 0.001, respectively). Subgroup A patients have significantly more extension of coronary diseases than subgroup B (P=0.001). A positive correlation was detected between RDW and WBC, CK-MB, Troponin T hs, HbA1C as well as number of diseased vessels in diabetic patients (0.76, 0.4, 0.98 and 0.79, respectively). Conclusion: Diabetic patients with acute STEMI had higher levels of RDW than non-diabetics and higher levels were positively correlated with inflammatory and poor outcome cardiovascular markers as well as multiple vessel diseases involvement. It was also correlated with poor glycemic control represented by high HbA1C.

Study of correlation of red cell distribution width with acute exacerbation of chronic obstructive pulmonary disease

Acute exacerbation of COPD is one of the most common disease in patients with infections, having frequent hospitalization. The aim of this study is to find whether there is any relationship between RDW with mortality in AECOPD. The hospital based case control Study is was conduct on hospitalized 50 patient with primary and final diagnosis of AECOPD and 50 patient of stable period of COPD. Socio-demographic variable in both groups were comparable. BMI was significantly lower in AECOPD patients. The mean PACK/YR in AECOPD group was 24.44±6.23 and in Stable COPD was 20.66±8.21. Mean admission per year were significantly higher in AECOPD patients (1.88±0.80 per year) as compare to stable COPD patients (0.80±0.67 per year). Mean FEV1 % was significantly lower in AECOPD patients (43.87±14.26) as compare to stable COPD patients (48.12±20.18). Mean RDW significantly higher in AECOPD (17.60±5.70%) as compare to stable COPD patients (13.80±3.33%). The difference in both groups was found statistically significant. MCV was significantly lower in AECOPD (82.04±1.49) as compare to stable COPD patients (86.50±1.87). The difference in both groups was found statistically significant. RDW was significantly higher in those patient who were died (19.50±0.70%) as compare to survived patients (17.52±5.61%). The difference in both groups was found statistically significant. 4.00% hospital mortality in AECOPD group. We have concluded that the mean red cell distribution width on the day of presenting the illness was significantly higher in AECOPD as compare to stable COPD. Those patients who had a high red cell distribution width during admission were associated with poor prognosis.