Red Blood Cell Distribution Width Values Research Articles

Red blood cell distribution width as a surrogate biomarker of damage and disease activity in patients with systemic lupus erythematosus.

Red blood cell distribution width (RDW) is a measure of variability in mean corpuscular volume. Alterations in RDW can be observed in a variety of human disorders, including inflammatory, cardiovascular, and hepatic or renal diseases. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect virtually any organ in the body. In this work, our objective was to analyse how a complete characterisation of disease characteristics in a large series of patients with SLE is related to RDW values. 284 patients with SLE and 181 age- and sex-matched healthy controls were recruited. Complete blood count including RDW was assessed. Multivariable analysis was performed to analyse the relationship between RDW and SLE disease characteristics, including composite scores of disease activity and damage. After multivariable adjustment, RDW was higher in patients with SLE compared to controls (beta coefficient 0.8 [95% confidence interval: 0.3-1] %, p=0.003). Several disease characteristics, such as the presence of extractable nuclear antibodies and antiphospholipid syndrome, and the use of prednisone and azathioprine, were significantly associated with higher levels of RDW after adjustment for confounders. Of note, cumulative disease damage and disease activity scores were associated with higher RDW values after controlling for covariates. RDW may serve as a surrogate biomarker of accrual disease damage and activity in patients with SLE.

Red Blood Cell Distribution Width as a Risk Factor for 30/90-Day Mortality in Patients with Gastrointestinal Bleeding: Analysis of the MIMIC-IV Database.

The purpose of this research was to assess the relationship between red blood cell distribution width (RDW) and mortality in patients with gastrointestinal (GIB) bleeding in the intensive care unit (ICU). The information of the participantswas obtained from the Medical Information Mart for Intensive Care IV database. The main outcome of this research was 30/90-day mortality, with ICU mortality and in-hospital mortality as secondary outcomes. This research included 2924 patients with gastrointestinal bleeding in total. Patients with higher RDW had considerably higher 30/90-day and in-hospital mortality rates,as well as longer hospital stays and ICUstays. According to the Kaplan-Meier analysis, the 30/90-day mortality rate was remarkably higher among participants in the higher RDW group (P < 0.0001). In the adjusted multivariate Cox regression analysis, for 30-day mortality, the HR (95% CI) was 1.75 (1.37, 2.24) in comparison to Q1 in the reference group (P < 0.001). Analyses of 90-day mortality and in-hospital mortality both showed the same results. In the subgroup analysis, gender, myocardial infarction, chronic pulmonary disease, cerebrovascular disease and renal disease had no significant effect on the correlation between RDW values and mortality (all P > 0.05). The area under the ROC curve for RDW was 0.599 (95% CI 0.581-0.617) and 0.606 (95% CI 0.588-0.624) in 30/90-day ICU mortality. The current research showed that RDW could be utilized as an independent indicator of short-term mortality in critically ill GIB patients at 30 and 90days of hospital admission.

The Association between Red Blood Cell Distribution Width and Mortality Risk after Hip Fracture: A Meta-Analysis.

Background and Objectives: Hip fractures in the elderly pose a considerable health risk and cause concern. Red blood cell distribution width (RDW) is a valuable marker for identifying patients at high risk of age-related mortality and various disorders and diseases. However, its association with poor patient outcomes following hip fractures has yet to be fully established. Hence, the purpose of this meta-analysis was to investigate and gain a better understanding of the relationship between RDW levels and the risk of mortality after hip fractures. Materials and Methods: PubMed, Embase, Web of Science, and other databases were comprehensively searched until April 2023 to identify relevant studies. The meta-analysis included observational studies finding the association between RDW at admission or preoperation and short-term and long-term mortality rates following hip fractures. The results were presented in terms of odds ratios (ORs) or hazard ratios (HRs) with corresponding 95% confidence intervals (CIs). Results: This meta-analysis included 10 studies involving 5834 patients with hip fractures. Patients with preoperative RDW of over 14.5% had higher risks of 1-year (OR: 5.40, 95% CI: 1.89-15.48, p = 0.002) and 3-month (OR: 2.91, 95% CI: 1.42-5.95, p = 0.004) mortality. Higher admission or preoperative RDW was significantly associated with an 11% higher mortality risk after 1 year (HR: 1.11, 95% CI: 1.06-1.17, p < 0.00001). Patients with higher preoperative RDW had a significantly higher risk of 6-month mortality, which was three times that of those with lower preoperative RDW (OR: 3.00, 95% CI: 1.60-5.61, p = 0.0006). Higher preoperative RDW was correlated to a higher 30-day mortality risk (OR: 6.44, 95% CI: 3.32-12.47, p < 0.00001). Conclusions: Greater RDW values at admission or before surgery were associated with a higher risk of short-term and long-term mortality following hip fractures. Because RDW can be easily measured using a routine blood test at a low cost, this parameter is promising as an indicator of mortality in elderly patients with hip fractures.

Diagnostic and prognostic value of PCT and RDW in premature infants with septicemia.

It aims to study the diagnostic effect of procalcitonin (PCT) and red blood cell distribution width (RDW) in premature septicemia (PS), and to analyze the prognostic evaluation value of PCT and RDW in PS. Ninety eight septicemia premature infants (SPI) who visited the neonatal intensive care unit of our hospital from June 2019 to July 2021 were selected and met the criteria. Based on the patient's condition and the neonatal shock score, they were separated into a severe group (SG) and a mild group (MG). There were 43 children and 55 children in the 2 groups, respectively. According to the survival status of SPI after 3 days of treatment, they were divided into a death group and a SG. It detected and analyzed the peripheral venous blood of SPI before treatment (BT) and after treatment (AT), and observed the changes of PCT and RDW. The comparison of general data between severe and mild SPI and their mothers did not have statistical significance (P > .05). The PCT of the SG was higher than that of the MG BT, on the 1st day and the 3rd day AT; The PCT BT and AT in both groups ranged from high to low on the 1st day and the 3rd day AT and BT (P < .05). The RDW in the SG were higher than those in the MG, and the RDW BT and AT in both groups were the highest on the 1st day AT; The RDW BT in the MG was higher than on the 3rd day AT, while the RDW BT in the SG was lower than on the 3rd day AT (P < .05). The optimal cutoff values for PCT on the 1st and 3rd day AT were 40.594ng/ml and 64.854ng/ml, respectively, with sensitivity of 100.0% and 100.0%, and specificity of 73.2% and 87.1% (P < .05). The optimal cutoff values for RDW on the 1st and 3rd day AT were 16.649% and 18.449%, respectively, with sensitivity of 100.0% and 100.0%, and specificity of 68.5% and 91.8% (P < .05). Monitoring the changes in PCT and RDW can promote the early diagnosis of PS and their prognosis evaluation.

RED CELL DISTRIBUTION WIDTH – AN IGNORED BUT EMERGING INDICATOR TO PREDICT ADVERSE EVENTS IN HYPERTENSIVE PATIENTS

Objectives: Hypertension (HT) is related to the development of ischemic heart disease, heart failure, stroke, and chronic kidney disease. It is one of the primary causes of long-term morbidity and mortality. Past studies showed that red blood cell (RBC) morphology plays a significant role in inflammatory conditions of HT. Hence, this study was conducted to find association of erythrocyte parameters like RBC distribution width (RDW) with arterial blood pressure in hypertensives. Methods: The study was conducted in two groups: study and control. Fifty hypertensives and 50 normotensives between 40 and 60 years, matching inclusion and exclusion criteria were involved, and blood samples were taken and analyzed. Results: Our study has found significantly low values of mean corpuscular volume and mean corpuscular hemoglobin in the study group. However, the study group shows significantly high RDW values as compared to control group. Conclusion: High RDW values in hypertensives are a strong indicator of RBC abnormality, and it is associated with various vascular complications along with end-organ damage.

The Value of RDW, PDW, and Immunoglobulin E in the Clinical Diagnosis of Pediatric Asthma

Objective: To observe and explore the value of the combined application of red blood cell distribution width (RDW), platelet distribution width (PDW), and immunoglobulin E (IgE) in the process of clinical diagnosis of children with asthma. Methods: Fifty-five children with suspected asthma were admitted to the hospital from July 2021 to July 2023. They underwent a bronchodilator test upon admission and their RDW, PDW, and IgE were detected. The efficacy of diagnosis with a single indicator (RDW/PDW/IgE) and combined parameters (PDW + PDW + IgE) were compared with the results of the bronchodilator test. Results: 49 cases of pediatric asthma were diagnosed by the bronchodilator test. RDW and PDW of asthmatic children were lower than those of non-asthmatic children, while the IgE of asthmatic children was higher than that of non-asthmatic children, and there was a significant difference in the RDW, PDW, and IgE among children with different degrees of asthma severity (P &lt; 0.05). The positive rate of the three combined diagnostic tests of RDW, PDW, and IgE was significantly higher than the positive rate of a single-parameter diagnosis (P &lt; 0.05). Conclusion: The combination of RDW, PDW, and IgE plays a crucial role in the clinical diagnosis of asthmatic children. These tests further improve the efficiency of clinical diagnosis and help identify the severity of the disease.

The value of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red blood cell distribution width in predicting positive surgical margin after laparoscopic radical prostatectomy.

Prostate cancer (PCa) is one of the most common malignant tumors in men, and laparoscopic radical prostatectomy (LRP) is commonly used to treat localized and advanced PCa. Positive surgical margin (PSM) is one of the most frequent problems faced by surgeons. This study aimed to explore the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in predicting PSM after LRP. Three hundred and twenty patients with PCa were admitted and underwent LRP in Beijing Chaoyang Hospital from January 2017 to June 2023. Patients were randomly divided into a training set (225 cases) and a validation set (95 cases) in a 7:3 ratio. NLR, PLR, and RDW were significantly higher in the PSM group than in the negative surgical margins (NSM) group. In addition, the NLR, PLR, and RDW values correlated with clinical T stage, Gleason score, and seminal vesicle invasion in the PSM group. In training set, ROC curve analysis revealed that the optimal cutoff values of NLR, PLR, and RDW for predicting postoperative PSM in PCa were 2.31, 115.40, and 12.85%, respectively. Multivariate Logistic regression analysis showed NLR and RDW were the clinical independent predictors. The area under the curve (AUC, 0.770, 95% CI 0.709-0.831) for postoperative PSM was the highest when a combination of the three parameters was used, with sensitivity and specificity of 62.5% and 85.2%, respectively. In validation set, the AUC values for NLR, PLR, RDW and the three markers combined were 0.708, 0.675, 0.723, and 0.780, respectively. Correlation analysis showed that in the PSM group, NLR was positively correlated with PLR and RDW, and PLR was positively correlated with RDW. By contrast, in the NSM group, a positive association was only found between NLR and PLR. Higher preoperative NLR, PLR, and RDW values were associated with postoperative PSM. Additionally, the three markers combined may be useful to predict PSM.

Prognostic value of red blood cell distribution width combined with chloride in predicting short- and long-term mortality in critically ill patients with congestive heart failure: Findings from the MIMIC-IV database

BackgroundHypochloremia and red blood cell distribution width (RDW) play important roles in congestive heart failure (CHF) pathophysiology, and they were associated with the prognosis of CHF. However, the prognostic value of chloride combined with RDW in patients with CHF remains unknown. MethodsWe retrospectively analyzed critically ill patients with CHF. The database was derived from the Medical Information Mart for Intensive Care IV v2.0 (MIMIC-IV-v2.0) database. ResultsIn the final analysis, 5376 critically ill patients with CHF were included, and 2428 patients (45.2 %) experienced 5-year mortality. The restricted cubic spline model revealed a positive correlation between RDW and 5-year mortality, whereas chloride showed a U-shaped correlation with 5-year mortality. The median values of RDW and chloride were used to classify patients into four groups: high chloride/low RDW, low chloride/low RDW, high chloride/high RDW, and low chloride/high RDW. We observed the prognostic value of RDW combined with chloride in the Cox proportional hazard model, in predicting 5-year mortality, in-hospital mortality and 1-year mortality. Furthermore, we discovered that patients with chronic kidney disease (CKD) had a higher 5-year mortality risk than patients without CKD. ConclusionWe found the translational potential role of chloride combined with RDW in prioritizing patients at high risk for short- and long-term mortality in a cohort of critically ill patients with CHF. Prospective multicenter investigations are warranted to validate our results.

ΔRDW Could Predict Major Adverse Cardiovascular Events in Patients with Heart Failure with Reduced Ejection Fraction After Sacubitril/Valsartan Treatment.

This study aimed to evaluate the association between red blood cell distribution width (RDW) changes and major adverse cardiovascular event (MACE) occurrences during sacubitril/valsartan treatment in patients with heart failure with reduced ejection fraction (HFrEF). This study retrospectively analyzed the medical records of patients with HFrEF hospitalized from April 2018 to February 2021. The patients were divided into two groups according to the inclusion of sacubitril/valsartan in the personal drug treatment regimen, the traditional and the sacubitril/valsartan group. RDW values before and after sacubitril/valsartan treatment were recorded respectively as RDW1 and RDW2. ΔRDW was defined as the difference between RDW2 and RDW1. The patients in the sacubitril/valsartan group were divided into two subgroups according to ΔRDW >0 or ≤0. MACEs, such as readmission for HF, acute myocardial infarction, ischemic stroke, and malignant arrhythmia and death, were recorded during the 1-year follow-up period in each group. MACE development was lower in patients treated with sacubitril/valsartan than those treated with conventional therapy (log-rank, P<0.001). The incidence of cardiac events during the follow-up period was greater in the group with ΔRDW >0 than in the group with ΔRDW ≤0 (Breslow, P<0.001). Increased RDW was associated with a higher likelihood of developing MACE than decreased RDW (odds ratio [OR] =2.055, 95% confidence interval [CI]:1.301-3.246), and the risk of developing MACE increased by 22.1% for each unit increase in RDW (OR=1.221, 95% CI:1.074-1.389). Sacubitril/valsartan treatment is effective in reducing the risk of MACEs in HFrEF. Additionally, RDW changes are predictors of MACEs after sacubitril/valsartan treatment.

Differences in RDW Values of COVID-19 Patients with Pneumonia and Without Pneumonia at RSUM and RSUDP NTB

Pneumonia coinfection in COVID-19 patients can be an important risk factor for patient mortality. Red blood cell distribution width (RDW) is a predictor that can determine clinical outcomes in patients with respiratory tract infections and serious illnesses, so researchers want to conduct research to determine the difference in RDW values in COVID-19 patients with and without pneumonia at RSUM and RSUDP NTB. The design of this research is cross sectional. The sampling technique used was consecutive sampling. There were 110 COVID-19 patient data used in this research. Data collection uses medical record notes. The statistical analysis used was the Mann-Whitney test. The average age of patients was 48 years ± 16 years. Most of the subjects were male (53.6%). The most common comorbidity was diabetes mellitus (21.8%). The average RDW values in COVID-19 patients with and without pneumonia were 13.9% and 13.1%. The difference in the mean RDW value in the two groups is 0.8%. This study found that clinically there were differences in the RDW values of COVID-19 patients with pneumonia and without pneumonia at RSUM and RSUDP NTB.

Cross-sectional association between red blood cell distribution width and regional cerebral tissue oxygen saturation in preterm infants in the first 14 days after birth.

Hypoxia can threaten the metabolic functions of different systems in immature neonates, particularly the central nervous system. The red blood cell distribution width (RDW) has recently been reported as a prognostic factor in neurologic diseases. Herein, we examined the correlation between RDW and regional cerebral tissue oxygen saturation (rcSO2). This cross-sectional study included 110 preterm infants born at a gestational age (GA) of <32 weeks, or with a birth weight (BW) of <1,500 g at our institution between January and June 2,022. The rcSO2 was monitored using near-infrared spectroscopy, and RDW was extracted from the complete blood count during the first 14 days after birth. RDW and rcSO2 measurements were analyzed using a cross-sectional research method. We divided the study population into two groups, with a mean rcSO2 value over the first 14 days. Fifty-three preterm had rcSO2 ≥ 55% and 57% < 55%. The 14-days-mean in the study population showing an association of lower rcSO2 values with higher RDW values. Significantly higher RDW values were observed in the low rcSO2 group compared with those in the high rcSO2 group. Threshold effect analysis showed that rcSO2 decreased with RDW values ≥18% (β, -0.03; 95% CI, -0.04 and -0.02; p ≥ 0.0001). After adjusting for potential confounders, an RDW of ≥18% was determined as the predictive cutoff value for preterm infants with low rcSO2 (Model I: OR, 3.31; 95% CI, 1.36-8.06; p = 0.009; and Model II: OR, 3.31; 95% CI, 1.28-8.53; p = 0.013). An RDW of ≥18% in the first 14 days is associated with rcSO2 of <55% in preterm infants.

Association of mean RDW values and changes in RDW with in-hospital mortality in ventilator-associated pneumonia (VAP): Evidence from MIMIC-IV database.

Ventilator-associated pneumonia (VAP) is a hospital-acquired infection with high mortality, and remains a challenge for clinical treatment. Red blood cell distribution width (RDW) was associated with worse outcomes in several diseases. The purpose of this study was to investigate the relationship between mean RDW values, changes in RDW (delta RDW), and in-hospital mortality among patients with VAP. In the present study, we enrolled 1266 VAP patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. All patients were categorized into low group, medium group, and high group according to tertiles of mean RDW values. The primary outcome was all-cause in-hospital mortality. Univariate logistic regression analysis, multivariate logistic regression analysis, and restricted cubic spline (RCS) curve were performed to determine the association between mean RDW values and in-hospital mortality in VAP. Moreover, RCS curve was plotted to explore the dose-response relationship between delta RDW and in-hospital mortality in VAP. Among the VAP patients included in the study, the in-hospital mortality was 20.85% with 264 non-survivors and 1002 survivors. The non-survivors exhibited significantly higher mean RDW values and delta RDW values compared to survivors. Multivariate logistic regression analysis indicated that mean RDW values were positively associated with in-hospital mortality in VAP after adjusting for relevant covariates. The RCS curve demonstrated a dose-response relationship between mean RDW and the mortality in VAP. Moreover, a linear relationship was observed between delta RDW and in-hospital mortality in VAP. Higher mean RDW values were significantly associated with an increased risk of in-hospital mortality in VAP. Additionally, a linear relationship was found between delta RDW values and in-hospital mortality. These findings suggest that RDW can be used to identify high-risk patients with poorer outcomes in VAP.

Relation between red blood cell distribution width and 30-day in-hospital mortality of patients with ventilator-associated pneumonia

BackgroundEpidemiological studies have demonstrated an association between red blood cell distribution width (RDW) and the prognosis of pneumonia-associated diseases. However, prognostic value of RDW in patients with ventilator-associated pneumonia (VAP) has yet to be investigated. This study aimed to explore the association between RDW and in-hospital mortality in VAP patients and explore predictive value of RDW for VAP patients.MethodsThis retrospective cohort study included 1,543 VAP patients from the Medical Information Mart for Intensive Care IV database 2008-2019. The primary outcome was considered to 30-day in-hospital mortality of VAP patients in this study. Non-high RDW level group was defined as <15 %, and high RDW level group as ≥15%. The possible confounding factors were screened by least absolute shrinkage and selection operator regression. Univariate and multivariate COX regression analyses were used for the assessment on the association of RDW and 30-day in-hospital mortality in VAP patients. We also performed subgroup analyses. Furthermore, a comparative analysis of RDW and sequential organ failure assessment (SOFA) score and simplified acute physiology score II (SAPS II) were performed by receiver operating characteristic (ROC) curves.ResultsThe 30-day in-hospital mortality of VAP patients was approximately 19.05%. After adjusting all confounding factors, high RDW was associated with 30-day in-hospital mortality among VAP patients by using non-high RDW as the reference [hazard ratio (HR) =1.29, 95% confidence interval (CI): 1.01-1.63]. Additionally, the relationship was also robust in several populations, such as patients were younger than 60 years, or had not a history of congestive heart failure, or had a history of sepsis, or had not received renal replacement therapy, or had a duration of mechanical ventilation for more than 7 days. The result of ROC indicated that RDW had a better prognostic value in predicting 30-day in-hospital mortality for VAP patients than SOFA score and SAPS II score.ConclusionHigh RDW level is associated with an increased 30-day in-hospital mortality. The RDW is a promising biomarker in predicting 30-day in-hospital mortality for patients admitted to the ICU, regardless of VAP.

Red Blood Cell Distribution Width (RDW) as a predictor of septic shock in children

Link of Video Abstract: https://youtu.be/Exh1T2szfoE Background: Septic shock is a prevalent PICU condition requiring prompt intervention. Using the PELOD II score, which has multiple characteristics to examine, it is challenging to predict prognosis in healthcare-limited settings. A link has recently been shown between red blood cell distribution width (RDW) and mortality risk in critically ill patients, albeit the exact mechanism is unknown. Methods: This retrospective observational study examined RDW values in pediatric septic or non-septic shock patients. This study examined patient clinical features, RDW hematological markers (RDW-CV, RDW-SD, and RDW/albumin ratio), and the area under the curve to determine the cut-off for the hematological marker, sensitivity, and specificity. Results: Sixty-one pediatric patients met the inclusion criteria (33 with septic shock and 28 with non-septic shock). The red cell distribution width coefficient variation (RDW-CV) (p=0,058), red cell distribution width standard deviation (RDW-SD) (p=0,05), and RDW Albumin Ratio (RAR) (p=0,014) were shown to be significantly different between the septic shock and non-septic shock groups. The cut-off value for RDW-CV was 15.3% (53.6% sensitivity and 97% specificity), 47.4 fl for RDW-SD (64.3% sensitivity and 84.8% specificity), and 5.65 for RDW/albumin ratio (71.4% sensitivity and 84.8% specificity). RDW-CV odd ratio was 36.9 (95% confidence interval (CI) 4.41-308.96, p 0.001), RDW-SD odd ratio was 10.08 (95% confidence interval (CI) 2.95-34.34, p 0,001), and RDW/albumin ratio was 14.00 (95% confidence interval (CI) 3.98-49.16, p 0,001). Conclusion: Increased RDW can be one marker in pediatric patients with septic shock. Increased levels of RDW/albumin ratio are significantly associated with the incidence of septic shock. Through the (ROC) area under the curve, the RDW/albumin ratio has better capabilities compared to other predictor markers.

Prognostic impact of red blood cell distribution width in chronic heart failure patients with left ventricular dysfunction.

Red blood cell (RBC) distribution width (RDW) measures RBC variations in size. Higher RDW values have been associated with poor outcome in acute heart failure (HF). We aimed to assess the prognostic impact of the RDW in chronic HF. We retrospectively analysed a cohort of chronic HF patients with left ventricular systolic dysfunction followed in our HF clinic between January 2012 and May 2018. Patients with missing data concerning RDW were excluded. Patients were categorized according to RDW tertiles: ≤13.5%; between 13.5 and 14.7%; and >14.7%. Patients were followed until January 2021; all-cause mortality was the end point analysed. The association of RDW with all-cause mortality was assessed with a Cox-regression analysis. Two multivariate models were built. We studied 860 chronic HF patients, 66.4% males, mean age 70 (standard deviation, SD 13) years. Patients were followed for a median of 49 (29-82) months. During this period, 423 (49.2%) patients died. Mortality increased with increasing RDW tertiles. Patients with RDW >14.7% had a HR of mortality of 1.95 (1.47-2.58), p < 0.001 (model 1) and of 1.81 (1.35-2.41), p < 0.001 (model 2) when compared with those with RDW ≤13.5. Patients in the second RDW tertile had an all-cause death HR of 1.47 (1.12-1.93) and of 1.44 (1.09-1.90) in models 1 and 2, respectively. Chronic HF patients with RDW values >14.7% presented an almost 2-fold higher risk of dying in the long term than those with RDW <13.5%. RDW is a widely available and easily measured parameter that can help clinicians in the risk stratification of chronic HF patients.

Red Blood Cell Distribution Width: A Novel Predictor of Mortality Following Amputation in Diabetic Foot

Category: Diabetes; Other Introduction/Purpose: Red blood cell distribution width (RDW) reflects the degree of heterogeneity of erythrocyte volume. The number of studies investigating the relationship between RDW and various human disorders has exponentially increased over the past decades. However, the association of RDW with diabetic foot amputation has not been evaluated to date. In this study, we assessed the value of RDW as a prognostic factor in diabetic foot amputation. Methods: Data on 415 patients with diabetic foot who underwent amputation between January 2009 and January 2019 were analyzed retrospectively. After establishing optimal cut-off point of preoperative RDW for all-cause mortality, univariable and multivariable analyses with Cox proportional hazard model for survivorship and logistic regression for length of hospital stay more than 30 days were performed to identify significant prognostic factors including RDW, other laboratory results, demographic variables and co-morbidities. Results: RDW cut-off of 14.5% was found to be significantly associated with all-cause mortality (P &lt; 0.001). High RDW was a significant risk factor or all-cause mortality (hazard ratio[HR]: 2.42, 95% confidence interval [CI]: 1.46 to 4.00) on multivariable- adjusted regression analysis. High RDW was also associated with longer hospitalization (odds ratio: 2.17, 95% CI: 1.29 to 3.66). Conclusion: High RDW over 14.5% value is an independent prognostic factor with increased mortality and prolonged hospital stay, implying that RDW may be a simple and inexpensive laboratory parameter for risk stratification in diabetic foot amputation.

Predictive value of red blood cell distribution width and platelet-to-lymphocyte ratio for acute kidney injury in critically ill patients.

The purpose of this study was to explore the value of red blood cell distribution width (RDW) and platelet-to-lymphocyte ratio (PLR) in predicting the occurrence of acute kidney injury (AKI) in critically ill patients. Among 1,500 adult patients in the intensive care unit (ICU) between January 2016 and December 2019, we examined the associations of baseline RDW and PLR with the risk of AKI development using logistical analysis. In addition, we explored the value of RDW and PLR in predicting in-hospital mortality. Overall, 615 (41%) patients were diagnosed with AKI. We divided the groups into two subgroups each; the high-RDW (≥14.045%) group had a high risk of developing AKI (OR=5.189, 95% CI: 4.088-6.588), and the high-PLR (≥172.067) group had a risk of developing AKI too (OR=9.11, 95% CI: 7.09-11.71). The areas under the receiver operating characteristic curves (AUCs) for the prediction of AKI incidence based on RDW and PLR were 0.780 (95% CI: 0.755-0.804) and 0.728 (95% CI: 0.702-0.754) (all p < 0.001), with cut-off values of 14.045 and 172.067, respectively. Moreover, a higher RDW was associated with a higher rate of hospital mortality (OR: 2.907, 2.190-3.858), and the risk of in-hospital mortality related to PLR was 1.534 (95% CI: 1.179-1.995). A higher RDW was related to a higher risk of AKI occurrence and in-hospital mortality in the ICU.

Comparison of visual assessments of anisocytosis in canine blood smears and analyzer-calculated red blood cell distribution width.

Red blood cell distribution width (RDW) and visual assessments of anisocytosis assess variability in erythrocyte size. Veterinary studies on the correlation between the two methods and on observer agreement are scarce. The objectives were to assess the correlation of the grading of anisocytosis by means of conventional microscopy of canine blood smears to RDW, and to assess intra- and inter-observer variation in assessing the degree of anisocytosis. The study included 100 canine blood samples on which blood smear examination and RDW measurement were performed. RDW was measured on the Advia 2120i analyzer. The degree of anisocytosis was based on a human grading scheme assessing the ratio between the size of the representative largest red blood cell and that of the representative smallest red blood cell (1+ if <2x, 2+ if 2-3x, 3+ if 3-4x, and 4+ if >4x). Three observers participated and assessed the blood smears by conventional microscopy twice, 3 weeks apart by each observer. The correlation was assessed for each observer on each occasion using Kendahl-tau-b analysis. Intra-observer agreement was assessed using quadratically weighted kappa. Inter-observer agreement was assessed using free-marginal multi-rater kappa. Anisocytosis graded on blood smears correlated significantly with RDW values as assessed by Kendahl-tau-b ranging between 0.37 and 0.51 (p < 0.0001). Intra-observer agreement ranged from weak to moderate with resulting kappa-coefficients being 0.58, 0.68, and 0.75, respectively. Inter-observer agreement was weak (Kappa-values 0.44). The weak to moderate observer agreement in the visual assessment of anisocytosis indicates that the more precise and more repeatable RDW measurement should be used for clinical decision-making.

Platelet and Erythrocyte Parameters in Type 2 Diabetic Moroccan Patients: A Cross-Sectional Study

Abstract Introduction Complete blood count parameters have gained renewed interest as predictors of endothelial dysfunction in type 2 diabetes mellitus (T2DM). Thus, the aim of this study was to observe the changes in platelet and erythrocyte parameters between diabetics and nondiabetics and to evaluate these changes in relation to glycemic control. Materials and Methods This cross-sectional study was performed in Mohammed VI University Hospital, Marrakech, Morocco, from January 2020 to July 2021. A total of 307 Moroccan patients were enrolled in this study, which included 222 diabetic patients and 85 nondiabetics. The diabetic patients were divided into two groups A (hemoglobin A1c [HbA1c] ≥ 6.5%) and B (HbA1c &lt; 6.5%) according to their glycated hemoglobin levels (HbA1c). Biological parameters were processed as per the standard technique. Data analysis was performed using SPSS statistical software. Results A significant difference was mentioned regarding mean corpuscular volume (MCV) (p &lt; 0.001), red blood cell distribution width (RDW) (p &lt; 0.001), and volume/platelet count (p = 0.023) between diabetics and nondiabetics. MCV and RDW were lower in group B than group A (p = 0.004; p = 0.04), while MPV was higher (p = 0.342). RDW significantly and negatively correlated with HbA1c in diabetic population (r = –0.182; p = 0.006). On the other hand, a significant and positive correlation between MPV and HbA1c was mentioned (r = +0.184; p = 0.006). Conclusion Our study showed that RDW and MPV correlate with HbA1c in T2DM and can be used as a reproducible and inexpensive means to ensure proper control of glycemic status. Further studies are warranted to define specific RDW and MPV values predictive of complication risk in the diabetic population.

Red blood cell distribution width for the prediction of outcomes after cardiac arrest

The red blood cell distribution width (RDW) is a routinely available blood marker that measures the variation of the size/volume of red blood cells. The aim of our study was to investigate the prognostic value of RDW in cardiac arrest patients and to assess whether RDW improves the prognostic value of three cardiac arrest-specific risk scores. Consecutive adult cardiac arrest patients admitted to the ICU of a Swiss university hospital were included. The primary outcome was poor neurological outcome at hospital discharge assessed by Cerebral Performance Category. Of 702 patients admitted to the ICU after cardiac arrest, 400 patients (57.0%) survived, of which 323 (80.8%) had a good neurological outcome. Higher mean RDW values showed an independent association with poor neurological outcomes at hospital discharge (adjusted OR 1.27, 95% CI 1.14 to 1.41; p < 0.001). Adding the maximum RDW value to the OHCA- CAHP- and PROLOGUE cardiac arrest scores improved prognostic performance. Within this cohort of cardiac arrest patients, RDW was an independent outcome predictor and slightly improved three cardiac arrest-specific risk scores. RDW may therefore support clinical decision-making.