Predictive Value Of Red Cell Distribution Width Research Articles

A CLINICAL STUDY TO FIND OUT THE RED CELL DISTRIBUTION WIDTH (RDW) CORRELATION WITH NEONATAL SEPSIS MORTALITY

Introduction: In developing countries like India neonatal sepsis is a major cause of mortality . Red cell distribution width (RDW) reflect the degree of inflammation and oxidative stress .As RDW is a readily available pramater and recent studies found that it can taken as a marker of mortality in critical patients 1,2,.However, its role in neonates remains unexplored. Hence, the objective of the present study was to evaluate the association of RDW with neonatal sepsis and its role as a predictive marker for outcome in neonatal sepsis.3, 5 Aims And Objectives: To find out the predictive value of RDW in relation to neonatal sepsis. Materials And Method: Prospective observational study was carried out in a NICU of Saraswathi Institute Of Medical Sciences for a period of 1 year. RDW values of septic neonates are compared with controls .A total of 50 septic neonates and 50 controls were enrolled of same gestational age and weight.RDW values are arranged as above 50th percentile and below 50th percentile. The outcomes of two groups are assessed in relation with RDW. Result And Conclusion: RDW levels were higher among septic neonates as compared to controls with p value of <.001.High RDW is associated with neonatal sepsis and it can take as a marker for mortality associated with neonatal sepsis.

Abstract TP261: Red Blood Cell Distribution Width is Associated With Collateral Flow and Infarct Volume Growth in Acute Stroke With Large Artery Atherosclerosis

Background and Purpose: Red cell distribution width (RDW) has been recognized as a prognostic marker in cardiovascular diseases and stroke. Increased RDW is predictive of poor outcome and mortality in acute ischemic stroke patients. However, the underlying mechanisms are not fully understood. We aimed to explore the association between RDW, collateral flow, infarct volume growth, final infarct volume (FIV), and clinical outcomes in acute stroke patients with large artery atherosclerosis. Methods: This is a single-center retrospective cohort study based on a prospective registry of consecutive acute ischemic stroke patients within 6 hours of onset. Acute ischemic stroke identified with anterior circulation large artery atherosclerosis (LAA) with complete baseline and follow-up imaging (Non-contrast CT, CT Angiography, Perfusion CT) as well as clinical profiles were enrolled. Collaterals was assessed using the volume ratio between delay time (DT) >3s and DT>6s lesions. Baseline infarct core volume was defined by relative cerebral blood flow<30%. FIV was calculated by manually drawing regions of interest on the follow-up images. Infarct volume growth was determined from FIV minus baseline infarct core volume. A good functional outcome was defined as a 3-month modified Rankin Score of 0-2. The relationship between RDW, collaterals, infarct volume growth, FIV and clinical outcomes were evaluated using multivariate models. Results: A total number of 100 patients were included in this study. Multivariate adjusted general linear models revealed that increased RDW was associated with poorer collaterals (multivariate adjusted coefficient -0.11, 95% CI -0.20 — -0.02, p=0.02) and increased infarct volume growth (multivariate adjusted coefficient 0.06, 95% CI 0.03 — 0.08, p<0.001). No significant relationship was found between RDW and FIV (multivariate adjusted coefficient 0.08, 95% CI -0.01 — 0.13, p=0.08), RDW and clinical outcomes (multivariate adjusted OR 1.66, 95% CI 0.44 — 6.28, p=0.46) probably due to the small sample size. Conclusion: For patients with LAA stroke, high RDW was associated with poorer collateral flow and increased infarct volume growth, which may explain the predictive value of RDW and poor functional outcomes in acute stroke.

Methotrexate therapy impacts on red cell distribution width and its predictive value for cardiovascular events in patients with rheumatoid arthritis

BackgroundMethotrexate (MTX) is well known to affect folic acid metabolism, so MTX treatment can result in alterations of mean corpuscular volume (MCV), which may impact on red cell distribution width (RDW), as MCV levels feed into RDW calculation. We thus questioned whether RDW levels and subsequently its diagnostic utility in RA subjects, as reported before, are influenced by ongoing MTX therapy.We assessed the impact of disease modifying drug (DMARD) treatment, especially MTX, on RDW and evaluated their influence on the predictive value of RDW for cardiovascular (CV) events in patients with rheumatoid arthritis (RA). As far as we know, this is the first study evaluating the influence of MTX on RDW.MethodsMedical treatment, disease activity, laboratory parameters and history of CV events were retrospectively analysed in 385 RA patients at disease onset and at last follow up at our clinic. Additionally, in patients with CV event, data were recorded at last follow up prior the CV event.ResultsDisease parameters and laboratory findings associated with a serious vascular event were older age (p < 0,001), longer disease duration (p = 0,002) and a higher RDW at diagnosis (p = 0,025). No differences in RDW levels became evident with any other treatment regimen beside MTX. MTX treated patients had significantly higher RDW compared to subjects without this drug (p < 0,001). In RA patients without MTX treatment, we found RDW level significantly different between those with versus without a CV event, whereas this difference disappeared in subjects receiving MTX.ConclusionMTX impacts on RDW and might therefor reduce its prognostic value for CV events in patients taking MTX, whereas an increased RDW at diagnosis remains an early risk predictor for myocardial infarction and stroke in RA patients.

Predictive values of red cell distribution width in assessing the severity of chronic heart failure

Objective To explore predictive value of baseline red cell distribution width (RDW) determined in a routine blood count for severity of chronic heart failure (CHF) and mortality during hospitalization. Methods The study group comprised 135 patients hospitalized in the our hospital with CHF in the Ⅱ~Ⅳ class according to New York Heart Association (NYHA). The control group included 44 patients in class Ⅰ. Hematological and biochemical parameters were obtained and compared among groups. Receiver operator characteristic (ROC) curves were used for assessing predictive values. Results RDW increased significantly in class Ⅲ and Ⅳ compared to class Ⅰ [(14.3±2.3)% and (14.3±1.7)% vs (12.9±0.8)%, P<0.01=. Areas under ROCs (AUCs) of RDW, N-terminal prohormone brain natriuretic peptide (NT-proBNP) for class Ⅳ HF was 0.817 and 0.840, respectively. RDW was significantly elevated in mortality group compared to survival group [(15.8 ± 1.8)% vs (13.7 ± 1.7)%, P<0.01=, predictive value of RDW was lower than that of NT-proBNP but was comparable to white blood cell (WBC), neutrophil (NEU), lymphocyte (L), and neutrophil /lymphocyte ratio (N/L) for mortality during hospitalization with AUCs (0.837, 0.939, 0.858, 0.891, 0.885, and 0.885, respectively). RDW and NT-proBNP showed low predictive values for repeated admission (≥3). RDW was an independent risk factor for mortality (OR=2.531, 95% CI: 1.371~4.671). Conclusions RDW increased significantly in class Ⅲ and Ⅳ patients and death group. The predictive value of RDW is comparable to NT-proBNP for class Ⅳ and lower than that of NT-proBNP for mortality. Elevated RDW is an independent risk factor for mortality. Key words: Erythrocytes; Heart failure

The Prognostic Significance of Inflammation-Associated Blood Cell Markers in Patients with Upper Tract Urothelial Carcinoma.

Inflammation-related parameters based on blood cells, including white blood cell (WBC) count, neutrophil-lymphocyte ratio, platelet count, and red cell distribution width (RDW), have been shown to be associated with prognosis in many cancers. However, no previous study evaluated these inflammation-associated markers simultaneously in upper tract urothelial carcinoma (UTUC). A total of 195 patients with UTUC who received radical nephroureterectomy between 2005 and 2010 were included retrospectively as the derivation cohort to investigate the impact of inflammation markers on overall survival (OS) and cancer-specific survival (CSS). In turn, another independent set of 225 patients were used for validation. Finally, we performed survival analysis in the combined cohort consisting of 420 UTUC patients. The predictive value of RDW and WBC count on outcome was replicable in different cohorts. Multivariate analysis showed high RDW was independently associated with poor OS (P < 0.001), and WBC count was a significant prognosticator for both OS and CSS (both P < 0.001). In subgroup analysis, we found the prognostic significance of RDW for OS was limited in organ-confined disease (≤pT2 without pN+). More importantly, a clear survival difference can be demonstrated by combining RDW and WBC count with other known prognostic factors in the risk stratification model. RDW and WBC count have the advantage of their common accessibility and are useful markers to predict outcome of UTUC in the preoperative setting. RDW and WBC count could provide additional prognostic value and help physicians identify patients at high risk for mortality and formulate individualized treatment strategy.

Red cell distribution width is associated with hospital mortality in unselected critically ill patients.

Red cell distribution width (RDW) is a variability of red cell sizes and has been associated with outcomes in many clinical settings. Its prognostic value in intensive care unit (ICU) has been reported but requires confirmation. The study aimed to investigate the role of RDW in predicting hospital mortality in critically ill patients. This is a retrospective study conducted in a 24-bed ICU of a tertiary teaching hospital. Data on demographic characteristics and laboratory measurements were collected from medical information database. Baseline variables were compared between survivors and nonsurvivors. The primary endpoint was hospital mortality; and ICU length of stays (LOS) were compared between patients with RDW >14.8% and ≤14.8%. The predictive value of RDW was also measured using receiver operating characteristic (ROC) curves. Two-sided P<0.05 was considered to be statistically significant. A total of 1,539 patients were enrolled during study period, including 1,084 survivors and 455 nonsurvivors. In univariate analysis, variables such as age, sex, primary diagnosis, C-reactive protein (CRP), RDW and albumin were significantly associated with hospital mortality. RDW remained significantly associated with mortality after adjustment for sex, age, Charlson index albumin and CRP, with an odds ratio of 1.1 (95% CI: 1.03-1.16). Diagnostic performance of RDW in predicting mortality appeared to be suboptimal (AU-ROC: 0.62). Changes in RDW during a short follow up period were not associated with mortality. RDW measured on ICU entry is associated with hospital mortality. Patients with higher RDW will have longer LOS in ICU. Repeated measurements of RDW provide no additional prognostic value in critically ill patients.

EFFECT OF MEASURES OF OBESITY ON THE ASSOCIATION BETWEEN RED CELL DISTRIBUTION WIDTH AND CARDIOVASCULAR MORTALITY AMONG REPRESENTATIVE U.S. ADULTS

Red cell distribution width (RDW), a novel biomarker, and anthropometric measures have been shown to be independent predictors of cardiovascular (CVD) events. We sought to explore the effect of anthropometric measures on predictive value of RDW for CVD, coronary heart disease (CHD) and all-cause