RDW In Patients Research Articles

Predictive value of red cell distribution width for overlap syndrome in obstructive sleep apnea

PurposeObstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are prevalent disorders, and the concurrence so-called overlap syndrome (OVS) is not rare either. Early recognition of OVS is essential because this group is more prone to cardiovascular morbidities and requires effective multidisciplinary follow-up. This study aimed to evaluate RDW in patients with severe OSAS and investigate whether it can predict OVS.Patients and methods96 patients were retrospectively analyzed, of whom 66 were found to have severe OSAS alone and 30 OVS during diagnostic workups. Demographic, polysomnographic, and laboratory results, including RDW, were compared between groups. Multivariate logistic regression was used to determine independent associates of OVS.ResultsGender and body mass index (BMI) were similar, however, the mean age and RDW were higher in the OVS group (p:0.008, p:0.002). The increase in RDW remained significant after adjustment for age, BMI, and cardiovascular risk factors. An RDW value of >13.65% was shown to have a 78.3% sensitivity and 60% specificity for predicting OVS in severe OSAS (p:0.004).ConclusionThe results suggest that RDW can be a reliable indicator for diagnosing OVS in OSAS. It can help in identifying the subset of patients who would benefit from proper consultations and multidisciplinary follow-up, leading to appropriate treatment of each disease component and effective monitoring to prevent adverse cardiovascular outcomes.

Evaluation of the Sensitivity of Prominent Biomarkers Involvement in Diagnosing the Severity of Lung Damage in Patients with COVID-19.

COVID-19 has become the greatest pandemic of the century. Considering the role of some hematologic and biochemical factors and their alterations due to the activity of the immune system, the current study aimed to evaluate LDH/CRP/ESR/RDW in patients with COVID-19 and their relationship with the severity of lung involvement based on CT scan findings. In this cross-sectional study, some biomarkers (LDH/CRP/ESR/RDW) were measured in 158 patients who were admitted to the intensive care unit (ICU) or hospitalized in the infectious diseases ward of Rasoul-e-Akram and Firoozgar hospitals or attended to the outpatient clinics. The diagnosis was confirmed by a positive RT-PCR test in all patients. The severity of lung involvement was determined by CT scan findings for comparison. Data were collected and analyzed through SPSS version 22. Regarding the severity of lung damage according to the CT scan, 17.7% of the patients were normal, 19% had less than 25% involvement, 17% had 25% -50% involvement, 33.5% had 50% -75% involvement, and 12% had more than 75% involvement. Considering the increasing severity of lung damage based on CT scans, the levels of RDW, ESR, CRP, and LDH significantly increased in parallel. The diagnostic value of RDW (cut-off point: 12.6, Sen: 73.1% (95%CI: 65.1-79.5), Sp: 53.6% (95%CI: 45.7-61.7), ESR (cut-off point: 49, Sen: 46.9% (95%CI: 38.2-54.5)), Sp: 85.7% (95%CI: 789.-90.5)), CRP (cut-off point: 23, Sen: 62.8% (95%CI: 54.6-70.4), Sp: 77.7% (95%CI: 70.3-84.1)) and LDH (cut-off point: 550, Sen: 65.1% (95%CI: 57.2-72.5), Sp: 85.7% (95%CI: 78.9-90.5)) were significant in diagnosing the severity of lung involvement (P < 0.05). The use of RDW, ESR, CRP, and LDH biomarkers could be effective in predicting the severity of lung damage in patients with COVID-19.

Širina distribucije crvenih krvnih zrnaca (RDW) je značajan prediktor preživljavanja kod pacijenata sa rakom larinksa - sistematski pregled literature i meta-analiza

Background: This systematic literature review and meta-analysis investigated whether the red blood cell distribution (RDW) may predict survival outcomes in laryngeal cancer patients undergoing curative treatment. Methods: We conducted an electronic search in Medline and Scopus using the keywords "red blood cell distribution width" OR "RDW" AND "laryngeal cancer" OR "larynx cancer" OR "laryngeal carcinoma" OR "larynx carcinoma," without time or language restrictions (up to February 2023), for identifying studies investigating the prognostic value of RDW in patients with any form of laryngeal cancer and with a primary endpoint that was set as survival rate and/or disease-free survival between 1 and 10 years after curative treatment. The research was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting checklist. Results: The digital search enabled us to identify five studies, that were finally included in our pooled analysis (survival rate and/or disease-free survival covered a window between 2.7-8.3 years). In four of the five studies, an enhanced RDW value in laryngeal cancer patients undergoing surgical or radiation treatment was associated with poorer survival (range of odds ratio ORs, 2.28-10.44). In the pooled analysis, increased RDW conferred an over 3fold higher risk of dying during follow-up after curative treatment for laryngeal cancer (OR, 3.37; 95%CI, 1.41-8.10). Conclusion: RDW retains a clinically important prognostic value in patients with laryngeal cancer undergoing curative treatment. Clinicians could acknowledge this information for using a more aggressive therapy or setting narrower follow-up in laryngeal cancer patients with increased RDW values.

Prognostic value of RDW at admission in patients with acute myocardial infarction

Objective: The aim of this study is to evaluate the effect of basal RDW value on the in-hospital prognosis (mortality, complications) in patients with acute myocardial infarction, in addition to comparing the prognostic value of RDW in patients with acute myocardial infarction with other laboratory indicators, and the relation between RDW and Global Registry of Acute Coronary Events GRACE score and progression of heart failure and Length of hospitalization Methods: a study applyed applied at Tishreen University Hospital in Lattakia-Syria during the period between February 2020-February 2021. The study included 145 acute myocardial infarction patients , and determination of the RDW value to study its effect on the prognostic of in-hospital mortality and complications. Results: A higher RDW value at admission was associated with higher rates of major cardiac complications such as cardiogenic shock (P = 0.007) and, arrhythmias (P = 0.0001) and a higher RDW value was associated with increased length of hospital stay (P = 0.01) and an increased death rate (P = 0.001). The statistically significant variables were entered into the logistic regression equation to identify the independent indicators for the warning of death within the hospital. We found that the high level of RDW is a prognostic biomarker of death in hospital (OR = 4.1, P = 0.0001), in addition to that in the case of previous coronary or peripheral vascular diseases (OR = 3.8, P = 0.006), lower EF (OR = 2.8, P = 0.001) and higher GRACE score (OR = 3.1, P = 0.002). Conclusion: In patients with acute myocardial infarction, high RDW has an independent predictive value for death, cardiogenic shock, and arrhythmias during hospitalization.

Distribution Width of Red Blood Cells and Related Factors Among Patients with End-Stage Renal Disease in Addis Ababa, Ethiopia.

BackgroundRDW is critical to the clinical diagnosis and progression of ESRD. There is currently little data on the relationship between RDW and ESRD in sub-Saharan Africa. Because of this, the present study evaluates RDW in patients with ESRD and associated factors in Addis Ababa, Ethiopia.MethodsThe hospital-based cross-sectional study design was conducted on a total of 83 patients. RDW, MCV, SCR, BUN, GFR, FBS and serum albumin were determined. Blood pressure (mmHg), weight (kg), height (m), MUAC (cm) and BMI (kg/m2) were also measured. Data entry was via Epi-data version 3.4 and analyzed with SPSS version 26.0. A multivariate logistic regression analysis with a p-value < 0.05 at a 95% confidence interval was used to identify the associated factors of RDW.ResultsA total of 83 ESRD patients participated, with a response rate of 95.4%. RDW ranged from 15.5% to 23.6% with a mean of 17.40% + 1.46%. Anisocytosis was present in 98.8% of patients. Of 83 patients, 66.3% were hypertensive, 20.5% had diabetes, and the remaining 13.3% had other conditions (glomerulonephritis and peripheral vascular disease). The mean GFR value was 5.20 mL/min/1.73 + 1.58. RDW showed a significant association with GFR (AOR: 4.6, 95% CI [1.27, 20.74], P = 0.047), alcohol consumption (AOR: 13.4, P = 0.012, 95% CI [1.97, 22.62]), recurrent kidney disease (AOR=25.6, P=0.016, 95% CI [1.85, 53.71]) and use of medication (AOR=00.2, P=0.044), 95% CI [0.03, 0.95]).ConclusionRDW showed a significant association with GFR, recurrent kidney disease, alcohol consumption, and medication use in hemodialysis-dependent ESRD patients. The mechanisms of RDW disruption in ESRD patients need further investigation.

Impact of red cell distribution width and red cell distribution width/albumin ratio on all-cause mortality in patients with type 2 diabetes and foot ulcers: a retrospective cohort study

BackgroundRed blood cell distribution width (RDW) has emerged as a prognostic factor for mortality in various diseases. Up to now, few studies have focused on the prognostic value of RDW in patients with diabetic foot ulcers (DFUs). This retrospective cohort study aimed to investigate the impact of RDW and RDW/albumin (ALB) ratio on all-cause mortality in patients with DFUs.MethodsThis study included 860 patients with DFUs in a tertiary academic hospital. The associations of RDW and RDW/ALB with all-cause mortality were assessed by multivariable cox regression analyses. The pairwise comparisons of receiver operating characteristic (ROC) curves were performed to compare the predictive performance of RDW and RDW/ALB ratio. Harrell’s concordance index, integrated discrimination improvement, and net reclassification improvement were used to estimate the improvements in risk discrimination.ResultsPatients with high RDW and RDW/ALB had lower overall survival rates (all P < 0.001). The multivariable Cox regression revealed that high RDW [adjusted hazard ratio (HR) 2.426, 95% confidence interval (CI): 1.557–3.778, P < 0.001] and high RDW/ALB (adjusted HR 2.360, 95% CI: 1.414–3.942, P = 0.001) were independent associated with high all-cause mortality. In subgroup analyses, the comparative analysis of ROC curves revealed that the discriminating ability of the RDW/ALB ratio was significantly superior to RDW in patients with no severe DFUs or no severe peripheral artery disease, or in young and middle-aged patients (all P < 0.05). Adding RDW and RDW/ALB ratio to base models improved discrimination and risk reclassification for all-cause mortality.ConclusionsRDW and RDW/ALB ratio are robust and independent prognostic markers in patients with DFUs. The RDW/ALB ratio appears to be of more predictive value for mortality in younger and less severely ill patients with DFUs. Both RDW and RDW/ALB ratio can provide incremental predictive value for all-cause mortality over traditional risk factors. RDW and RDW/ALB ratio can be used to identify high-risk patients with DFUs.

Effect of hyperlipidemia and change in HbA1c on MPV and RDW in patients with diabetes mellitus

Amaç: Diabetes mellitus (DM) subklinik, sistemik, düşük dereceli inflamatuvar bir endotel hastalığı olarak kabul görmektedir. Ortalama trombosit hacmi (MPV) ve eritrosit dağılım aralığı (RDW) birçok çalışmada inflamasyon ile ilişkisi araştırılmış olan hematolojik parametrelerdir. Çalışmamızda amacımız DM tanılı hastalarda HbA1c ve lipid profili ile hematolojik parametrelerden MPV ve RDW ilişkisini incelemek olmuştur.&#x0D; Gereç ve Yöntem: Retrospektif olarak planlanan çalışmaya tip 2 DM tanılı 100 hasta alındı. Diyabet tanı tarihleri, kan şekeri regülasyonu için aldıkları tedavi, diyabet ilişkili mikro ve makrovasküler komplikasyonları, HbA1c’nin yüksek olduğu dönemde ve tedavi sonrasında HbA1c’nin düştüğü dönemde açlık ve tokluk kan glukozu, lipid profili, hematolojik parametreleri retrospektif olarak incelendi.&#x0D; Bulgular: Çalışmaya 58 kadın ve 42 erkek hasta dahil edildi. Ortalama DM tanı süresi 3 yıl 3 ay olarak bulundu. Hastaların ilk başvuru anındaki ortalama HbA1c %9,4 iken aynı hasta grubunun kontrol muayenesi başvurusunda ortalama HbA1c %7,4 olarak saptandı. Her iki grup karşılaştırıldığında RDW (p:0,009) için anlamlı farklılık tespit edilmesine rağmen MPV (p:0,902) için anlamlı farklılık tespit edilmemiştir.&#x0D; Sonuç: Bu çalışmada HbA1c değerindeki düşüş sonrası RDW değerinde artış olduğu sonucuna varılmıştır. MPV için DM tanılı hastalarda istatistiksel anlamlılık saptanmamıştır. HbA1c değerine alternatif olarak RDW değerinin de takipte kullanılabileceği, MPV için daha fazla hasta sayısı ile çok merkezli çalışmalara ihtiyaç olduğu düşünülmektedir.

Red cell distribution width (RDW): a prognostic indicator of severe COVID-19

BackgroundThe global mortality rate for coronavirus disease 2019 (COVID-19) is 3.68%, but the mortality rate for critically ill patients is as high as 50%. Therefore, the exploration of prognostic predictors for patients with COVID-19 is vital for prompt clinical intervention. Our study aims to explore the predictive value of hematological parameters in the prognosis of patients with severe COVID-19.MethodsNinety-eight patients who were diagnosed with COVID-19 at Jingzhou Central Hospital and Central Hospital of Wuhan, Hubei Province, were included in this study.ResultsThe median age of the patients was 59 [28–80] years; the median age of patients with a good prognosis was 56 [28–79] years, and the median age of patients with a poor outcome was 67 [35–80] years. The patients in the poor outcome group were older than the patients in the good outcome group (P<0.05). The comparison of hematological parameters showed that lymphocyte count (Lym#), red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were significantly lower in the poor outcome group than in the good outcome group (P<0.05). Further, the red cell volume distribution width-CV (RDW-CV) and red cell volume distribution width-SD (RDW-SD) were significantly higher in the poor outcome group than in the good outcome group (P<0.0001). Receiver operating characteristic (ROC) curves showed RDW-SD, with an area under the ROC curve (AUC) of 0.870 [95% confidence interval (CI) 0.796–0.943], was the most significant single parameter for predicting the prognosis of severe patients. When the cut-off value was 42.15, the sensitivity and specificity of RDW-SD for predicting the prognosis of severe patients were 73.1% and 80.2%, respectively. Reticulocyte (RET) channel results showed the RET level was significantly higher in critical patients than in moderate patients and severe patients (P<0.05), which may be one cause of the elevated RDW in patients with a poor outcome.ConclusionsIn this study, the hematological parameters of COVID-19 patients were statistically analyzed. RDW was found to be a prognostic predictor for patients with severe COVID-19, and the increase in RET may contribute to elevated RDW.

Red Cell Distribution Width as a Marker of Inflammation in Type 2 Diabetes Mellitus

AbstractBackground: Red Blood Cell Distribution (RDW) is recognized as a global marker of chronic inflammation.Aim of Study: To study the relation between RDW and complications in patients with type 2 diabetes mellitus and its relation to CRP.Methods: The study included 70 patients with type 2 DM and 20 healthy controls with clinical and laboratory data including HbA1c, RDW and C Reactive Protein (CRP).Results: Patient group showed 65 (92.85%) of them had macrovascular and 64 (91.42%) patients had microvascular complications. When we compared patients with macrovascular and microvascular complications to control group we found high RDW in those with vascular complications than control group (p=0.001). There was a significant difference between RDW in patients with macrovascular complications in com-parison to those without macrovascular complications (p-value=0.02). There was a significant difference between RDW in patients with nephropathy compared to those with retinop-athy.Conclusion: In our study, we confirmed a strong relation between diabetics with vascular complications and RDW.

The utility of RDW in discrimination of sarcoidosis and tuberculous lymphadenitis diagnosed by ebus.

Erythrocyte distribution width (RDW) is an important indicator of anisocytosis, which is used in the differential diagnosis of anemia and is easily accessible in the complete blood count results. Increased RDW values in coronary artery diseases, pulmonary hypertension and malignancies were detected in the studies. We aimed to demonstrate the usefulness of blood RDW level for the differential diagnosis of granulomatous lymphadenitis associated with tuberculosis and sarcoidosis in our study. A total of 331 patients, 229 with sarcoidosis (stage I and stage II) and 102 with TB-LA and 50 healthy control group were included in the study. The biopsies were obtained via EBUS-TBNA from 705 lymph nodes of 331 patients. Of tissue diagnosis was non-erosive granulomatous inflammation patients with tuberculosis negative proved by microbiological tests were accepted as sarcoidosis after other causes of granulomatous disease were excluded. Of the sarcoidosis patients, 169 (73.7%) were in stage I, and 60 (26.3%) were in stage II. The mean RDW was 14.31 (± 1.6) in the stage I group, 14.99 (± 2.3) in the stage II group, 14.11 (± 2.0) in the TB-LA group, and 13.89 (± 1.3) in the control group. There was a significant difference between the stage II group and the stage I, TB-LA, and control groups (p< 0.05 for all). There was a significant difference in the C-reactive protein levels between the TB-LA and stage I groups (p< 0.01). The eritrocyte sedimentation rate values were higher in the TB-LA group than in both the stage I and stage II groups (p< 0.05). This is the first study to demonstrate the diagnostic value of RDW in patients with TB-LA and sarcoidosis (Stage I-II) patients diagnosed by EBUS-TBNA. Higher RDW in stage II sarcoidosis than in stage I, TB-LA and control group is related with parenchymal involvement and indicates active inflammation.

Red blood cell distribution width as a prognostic marker in patients with heart failure and diabetes mellitus

BackgroundRed blood cell distribution width (RDW) is an established prognostic marker in acute and chronic heart failure (HF). Recent studies have pointed out a link among RDW, diabetes mellitus (DM) and inflammation. We sought to investigate the prognostic value and longitudinal pattern of RDW in patients with concomitant HF and DM, which remains unknown.MethodsA total of 218 patients (71 diabetics) who presented with acute HF had RDW measured at admission, discharge and 4, 8 and 12 months post-discharge. The study endpoint was all-cause mortality or rehospitalization for HF during 1-year follow-up.ResultsThe study endpoint was met in 33 patients (46.5%) with DM and in 54 patients (36.7%) without DM. RDW at admission was associated with higher event rate both in HF patients with and without DM (adjusted HR: 1.349, p = 0.002, 95% CI 1.120–1.624 and adjusted HR: 1.142, p = 0.033, 95% CI 1.011–1.291 respectively). In addition, a significant interaction was found between diabetes and RDW longitudinal changes (βinteraction = −0.002; SE = 0.001; p = 0.042).ConclusionsDespite the similar prognostic significance of RDW in diabetic and non-diabetic HF patients regarding the study endpoint, longitudinal changes were found to be significantly different between these two groups of HF patients. This might be due to the higher inflammatory burden that diabetic HF patients carry and may provide new insights to the pathophysiological mechanism of RDW increase in HF, which remains unknown.

The relationship of hematoma growth to rdw in patients with hypertensive intracerebral hemorrhage

Hypertension is a primary risk factor for intracerebral hemorrhage (ICH) and is thought to be responsible for about 55% of all ICH cases. Thus, the primary goal of the study was to examine whether the status of vascular rheological factors upon admission to the hospital was associated with hypertensive ICH growth and early outcomes. Over a 2-year period, the present study evaluated 60 ICH patients who were admitted within the first 12 hours of symptom onset. Brain computed tomography scans were performed at admission and then 24 hours later as a control. Hematoma growth was classified as an volume increase more than 6.5 ml or > 33%, and good outcome was defined using the modified Rankin Scale (mRS) score (? 2 at 3 months). The mean age of the study population was 65.07 ± 11.659 years, with 34 men and 26 women. The leading vascular risk factor was hypertension (86.7%). There were significant associations between the initial red blood cell distribution width (RDW) and hematoma growth (p=0.038). Therefore, hematoma growth in the first 24 hours after symptom onset was significantly related to a poor clinical outcome at 3 months (p = 0.050). The study identified significant relationships between the initial RDW and poor outcome as well as the initial RDW and hypertensive hematoma growth. Additionally, this study demonstrated that these parameters are easily obtainable and could be used to effectively evaluate outcomes in ICH patients.

The value of red blood cell distribution width in endometrial cancer.

Red cell distribution width (RDW) is a routinely examined parameter with the complete blood count. In recent studies, RDW levels have been associated with cardiovascular, liver and renal diseases and solid tumors. The aim of this study was to evaluate the alterations of RDW levels in benign and malignant causes of postmenopausal bleeding and to investigate the association of RDW levels with clinicopathological parameters of endometrial cancer (EC) patients. A retrospective study was made of a total of 884 females who were admitted to hospital for postmenopausal bleeding between May 2009 and December 2013. After inclusion and exclusion criteria were applied, 222 patients remained. Complete blood count data was obtained from the recorded computerized database. After pathological evaluation, the patients were divided into two groups, benign and malignant (EC). The EC group (n=113) had significantly higher RDW levels compared to the benign group (14.78±2.02 vs. 13.88±1.05; p=0.000). Grade II and above EC patients had higher levels of RDW than Grade I patients (15.2±2.3 vs. 14.1±1.00; p=0.005). Correlation analyses also revealed a negative correlation between RDW and hemoglobin levels (p=0.000), RDW and mean corpuscular volume (p=0.000), RDW and lymphocyte count (p=0.035) but a positive correlation between RDW and platelet to lymphocyte ratio (p=0.030). The results of the current study revealed the potential predicitve role of RDW in patients with postmenopausal bleeding. Significant associations were also determined between RDW and clinicopathological characteristics in EC patients.

The association of red blood cell distribution width with anemia and inflammation in patients with Takayasu arteritis

BackgroundRed blood cell distribution width (RDW) has been shown to be related to both anemia and inflammation in various diseases. However, the role of RDW in patients with Takayasu arteritis (TA) is unknown. Therefore, we investigated the association of RDW with anemia, inflammation, and disease activity in TA. MethodsRDW was determined in 156 patients with TA and in 156 control subjects. Anemia status and disease activity were defined according to the World Health Organization and National Institutes of Health criteria, respectively. ResultsRDW was significantly increased in patients with anemia (14.6±2.2) compared with those without anemia (13.6±1.3, p<0.001) and control subjects (12.7±0.6, p<0.001). Regardless of the presence of anemia, RDW showed correlation with high-sensitivity C-reactive protein (hs-CRP) (both p<0.05). RDW was higher in active TA than inactive TA in patients without anemia (14.1±1.5 vs. 13.3±1.1, p=0.001). Moreover, multiple regression analysis showed that hs-CRP and mean corpuscular volume were independently associated with RDW. ConclusionsRDW is influenced by both anemia and inflammation, and RDW may be a useful marker to assess disease activity in patients without anemia.