Red Cell Distribution Width Measurement Research Articles

RED CELL DISTRIBUTION WIDTH VALUE AS A PREDICTOR OF COPD SEVERITY: ORIGINAL RESEARCH ARTICLE

Objectives: The purpose of the study is to use the red cell distribution width (RDW) value for predicting chronic obstructive pulmonary disease (COPD) severity. Methods: Three hundred COPD patients are included in this retrospective analysis. Oxygen saturation, BODE index variables, and demographic characteristics were noted. All patients’ survival data were analyzed. RDW measurements were evaluated at the time of inclusion. Results: The patients had an average age of 65.2±8.6 years. The patients were divided into the following stages of COPD: stage 1: 14.66%, stage 2: 56.66%, stage 3: 25.6%, and stage 4: 3%. Red cell distribution width was observed differ significantly between stages. The very high RDW was found in the extremely serious stage (p<0.001). The BODE index has a median of 1 (0–3). RDW increased with the BODE index as it increased (p<0.001). The survival percentages for the groups of patients created based on the laboratory upper limit of RDW was 76% for groups with RDW<14.3% and 29% for groups with RDW>14.3%. Conclusion: Our study’s findings suggest that an elevated level of RDW may be linked to increased mortality and that a quick, non-invasive test could be used as an early biomarker to assess the severity of a disease.

Red cell distribution width as a prognostic marker for complications of community-acquired pneumonia in children: a comparison with Proadrenomedullin and Copeptin

BackgroundCommunity-acquired pneumonia (CAP) is the most common leading cause of morbidity and mortality in children; so, early identification of patients with CAP, who are at risk of complications or high mortality, is very critical to identify patients who need early admission to the intensive care unit.Purpose of the studyTo explore the prognostic value of Red Cell Distribution Width (RDW), Proadrenomedullin and Copeptin in the prediction of complicated CAP in children.Methods99 children were enrolled in the study, which was done at the Pediatric Department of Minia University Hospital. Measurement of serum Proadrenomedullin, Copeptin, and RDW was done to all participating children in the first 24 h of admission. Assessment of the severity of CAP was done using the Pediatric Respiratory Severity Score (PRESS).ResultsThe values of RDW, Proadrenomedullin, and Copeptin were significantly higher in the complicated CAP group than in the uncomplicated one (P value < 0.01). There were significant positive correlations between RDW and Proadrenomedullin with PRESS (r 0.56 for both). For the prediction of complications, RDW at cutoff point > 17.4, has 77.7% of sensitivity and 98.6% of specificity, followed by Pro ADM at cutoff point > 5.1 nmol/L, of 74% of sensitivity and 90.2% of specificity. For the prediction of mortality, RDW at cutoff point > 17.4 has 81.25% of sensitivity and 89.16% of specificity.ConclusionThe RDW is a reliable predictor of poor outcomes in pediatric CAP.

Red cell distribution width and Glasgow coma scale score as predictors of in-hospital mortality in maintenance hemodialysis patients diagnosed with spontaneous intracerebral hemorrhage.

Glasgow Coma Scale (GCS) score is being widely used as a useful predictor to investigate patients with head injury. High red cell distribution width (RDW) values have been independently associated with mortality and poor neurological outcome. However, there are few data available for Spontaneous Intracerebral Hemorrhage (SIH) in maintenance hemodialysis (MHD) patients. This study aimed to evaluate the prognostic value of the combined measurement of RDW and GCS score in MHD patients with SIH. We retrospectively studied 46 MHD patients who was admitted to our hospital for nontraumatic SIH from October 2014 to May 2020. Data including demographic information, cause of renal failure, comorbidities at ESRD, clinical and laboratory parameters at admission were collected from medical records. Univariate and multivariate Logistic regression analysis were performed to identify independent risk factors of the in-hospital Mortality in Hemodialysis Patients with SIH. The receiver operating characteristic curve (ROC) and areas under the curve (AUCs) were determined. The sensitivity and specificity of independent risk factors were calculated for a range of different cutoff points. A total of 46 patients were enrolled in the study. The in-hospital mortality rate was 69.57%. We divided subjects into 2 groups based on the clinical outcomes. Compared with survivors (n = 14), non-survivors (n = 32) had longer hemodialysis vintage (P = .017), lower GCS score (P < .001), higher hemoglobin (Hb) (P = .032) and RDW (P = .009). In multivariate logistic regression analysis, GCS score (OR 0.719, 95% CI 0.546-0.946; P = .018) and RDW (OR 4.549, 95% CI 1.243-0.946; P = .018) were independent risk factors of in-hospital mortality in MHD patients with SIH. The area under the ROC curve (AUC) for GCS score was 0.849 (95% CI 0.729-0.970) while that for RDW was 0.743 (95% CI 0.596-0.891). The AUC for the combined prediction was 0.916 (95% CI 0.828-1.000), with a sensitivity of 90.63% and a specificity of 88.46%. In conclusion, high RDW and low GCS score were useful and independent poor prognostic markers for in-hospital mortality of MHD patients with SIH.

Elevated red cell distribution width and cardiovascular mortality in ASCVD risk cohorts: National Health and Nutrition Examination Survey (NHANES III).

Although red cell distribution width (RDW) is associated with increased cardiovascular mortality, the relationship between an elevated RDW and cardiovascular mortality among various ASCVD risk groups is unknown. We utilized the National Health and Nutrition Examination Survey (NHANES) III, which uses a complex, multistage, clustered design to represent the civilian, community-based US population. Out of 30,818 subjects whose data were entered during the 1988-1994 period, 8884 subjects over 40 years of age, representing a weighted sample of 85,323,902 patients, were selected after excluding missing variables. The ACC/AHA pooled cohort equation (PCE) was used to calculate atherosclerotic cardiovascular disease (ASCVD) risk, and low (<7.5%), intermediate (7.5-20%), and high (>20%) risk groups were created. The primary endpoint was cardiovascular mortality. A multivariate proportional hazard regression was performed using the Fine and Gray (sub-distribution) method. Red cell distribution (RDW), C-reactive protein (CRP), age, sex, race, diabetes, smoking status, high-density lipoprotein (HDL), and chronic kidney disease (CKD) were used as covariates in each of the ACC/AHA pooled cohort risk groups. The adjusted hazard ratios for RDW >14 (Normal range 12.5-14.5 %) as compared to <13 were 2.79 (95% confidence intervals (95% CI) 2.77-2.81, p < 0.01), 2.02 (95% CI 2.01-2.02, p < 0.01), 1.18 (95% CI 1.18-1.18, p < 0.01) in the low, intermediate and high-risk groups respectively. The 20-year cumulative cardiovascular mortality (RDW >14 vs. <13) was 4% vs. 1.3% low, 17.7% vs. 7.7% in intermediate and 28.1% vs. 24.6% in high ASCVD risk groups respectively. Our findings support that measurement of RDW in the intermediate ASCVD group may be clinically valuable for further risk stratification and prognostication in the general population of people aged more than 40 years of age with regards to identifying those at an increased risk for cardiovascular mortality.

Assessment of the clinical value of red cell distribution width in patients with de novo hepatocellular carcinoma following HCV clearance with direct-acting antiviral

Background: The Red cell distribution width (RDW) shows a significant increase both in the hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Treatment of HCV has changed following the introduction of direct-acting antivirals (DAAs) with a higher sustained virological response rate (SVR). However, HCC is still developed after DAAs therapy. Aim: The study aimed to assess the changes of RDW in HCC patients with HCV viremia and after SVR12 to DAAs. Methods: This work is based on a retrospective cohort study including 120 patients allocated into 3 groups, 40 / each. Group 1: patients with HCV-related liver cirrhosis without HCC and not treated with DAAs, group 2: patients with liver cirrhosis and HCC without DAAs and group 3: patients with liver cirrhosis and developed HCC following SVR12 to DAAs. Liver profile, International Normalized Ratio (INR) and creatinine indices were measured with an assessment of Child class CBC for measurement of RDW and RDW/Platelet ratio (RPR) were done. Results: The red distribution width (RDW) was mildly elevated in group 3 compared to group 2. The ratio of RDW/Platelet was almost similar in group 2 and group 3. RDW increased in group 3 relative to group 2 in all Child classes with a significantly higher level in Child A and B. Conclusion: Clearance of HCV following DAAs did not have a major impact on RDW in HCC patients after DAAs therapy which is not different from viremic patients with HCC.

Red Cell Distribution Width As a Predictor of Mortality in Patients With Sepsis.

IntroductionSepsis is a common medical condition that is associated with very high mortality and, in survivors, long-term morbidity. Conventional inflammatory markers, such as CRP, erythrocyte sedimentation rate (ESR), and white blood cell count (WBC), have proven to have a limited utility in sepsis patients by virtue of their poor sensitivity and specificity for infections. Recently, the commonly used index of red cell distribution width (RDW) has been implicated as a prognostic marker in sepsis. This study aimed at assessing the role of RDW in predicting outcomes such as mortality in patients with sepsis and to study its role as a prognostic marker.MethodsThis was conducted as a prospective comparative observational study over a two year period between 2018 and 2020 in a tertiary care center in South India. In total, 60 adult patients above 18 years of age who were diagnosed to have severe sepsis and septic shock were selected to be part of the study. To find the survival probability on overall survival, Kaplan-Meier analysis was used and a comparison was done using the Log-rank test. To find the most significant predictors of mortality, cox regression analysis was applied.ResultsA total of 60 patients (n=60) were enrolled in this study out of which 30 (50%) patients had a rise in RDW and 30 (50%) patients had a fall in RDW. A total of 17 (28.3%) patients died during this study. In the rise in RDW group, there were 12 (40%) deaths while in the fall in the RDW group, there were five (16.7%) deaths. There was a statistically significant association found between mortality with rise and fall in RDW (p<0.05). A cox multivariate regression analysis demonstrated statistically significant associations between a rise in RDW (p<0.05, HR: 5.6, CI 1.4 to 21.9) and serum hemoglobin < 13.6 g/dL (p<0.05, HR: 3.6, CI 1.1 to 11.4) with mortality in this study. Kaplan-Meier analysis of rise and fall in RDW with survival trended towards better survival outcomes in the fall in the RDW group but was not significant (p=0.07).ConclusionWe found that an increase in RDW from baseline during the initial 72 hours after admission is significantly associated with adverse clinical outcomes including mortality. The mortality in the rise in the RDW group, as well as overall mortality, were significantly higher than the mortality in the reduced RDW group. Hence, serial RDW measurements could be used as a prognostic factor in severe sepsis and septic shock.

Koroner Arter Cerrahisi Geçiren Hastalarda İntravenöz Anestezi ve İnhalasyon Anestezisinin Kırmızı Hücre Dağılım Genişliği ve Ortalama Platelet Volümü Üzerine Etkileri

INTRODUCTION: The effects of midazolam-based intravenous anesthesia (TIVA) and sevoflurane-based inhalation anesthesia (SEVO) maintenance on postoperative hematological parameters were compared in patients undergoing coronary artery surgery. METHODS: The 100 patients included in the study were divided into two groups according to the anesthesia management: All patients' anesthesia inductions were performed with 10 μgkg-1 fentanyl, 0.15 mgkg-1 midazolam, and 0.8 mgkg-1 rocuronium. Anesthesia was maintained with total intravenous anesthesia in the TIVA group patients, while sevoflurane was used in the SEVO group patients. Demographic, clinical, operative data, red cell distribution width (RDW), and mean platelet volume (MPV) values were recorded. RESULTS: Except that the extubation time was shorter in the SEVO group, no difference was observed between the groups in terms of all these variables. There was a significant increase in postoperative RDW and MPV measurements in both groups. Postoperative RDW value was lower in the inhalation anesthesia group compared to the TIVA group (p=0.013). DISCUSSION AND CONCLUSION: In our study, RDW was found to be lower in the inhalation anesthesia group, indicating less inflammation. There was no difference in terms of postoperative complications and mortality.

Correlation between Red Cell Distribution Width (RDW) with Kidney Function and Hematologic Parameters in Patients undergo Regular Hemodialysis

Background. Red cell distribution width (RDW) is a coefficient of variation in red blood cells that can decrease erythropoesis or increase the destructiveness of red blood cells. The objectives of research to determine the relationship of RDW as an inflammatory marker with renal function and hematological parameters in patients undergoing regular hemodialysis&#x0D; Method; Cross sectional research on 20 patients undergoing regular hemodialysis &gt; 3 months in RSUP H Adam Malik Medan. Vital sign, antropometry and venous blood retrieval are performed shortly before hemodialysis. RDW measurement comes from the red blood cell distribution curve in hematological analysis and is an indicator of variation in red blood cell size.&#x0D; Result: out of 20 subjek studies, there were 13 men (65.0%) and 7 (35.0%) women The majority of subjects had comorbid diabetes mellitus 14 (70.0%), hypertension 4 (20.0%). The average length of time patients underwent hemodialysis was 24.45 ± 20.98 months. There is a significant correlation between RBW and creatinine, Hb, and neutropil (r: 0.519, p:0,019*; r: 0.497, p: 0.026*;r: 0.464, p: 0.039*, respectively)&#x0D; Conclusion: There is a significant relationship between RBW and creatinine, Hb and neutropphils in patients undergoing regular hemodialysis &gt; 3 months.

A RETROSPECTIVE STUDY OF RED CELL DISTRIBUTION WIDTH AND RIGHT VENTRICULAR SYSTOLIC PRESSURE IN PULMONARY HYPERTENSION

SESSION TITLE: Pulmonary Vascular Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Red Cell Distribution Width (RDW), a measure that reflects the non-homogeneity in sizes of red cells, is a cheap and readily available parameter that has been correlated to various cardiac hemodynamic variables. The 6th World Symposium on Pulmonary Hypertension (PH) recently redefined PH to include all patients with a mean pulmonary artery pressure (mPAP) of greater than 20 mm Hg. Right Ventricular Systolic Pressure (RVSP) on transthoracic echocardiography is usually the first measured parameter when evaluating a patient for PH. We aimed to study the correlation between RDW and RVSP, so as to assess the potential role of RDW as a risk-stratifying aid for PH. METHODS: Patients who underwent right heart catheterization (RHC) at our center between November 2014 and November 2019 were included in this retrospective study. Exclusion criteria included patients under the age of 18, active malignancy, known hemoglobinopathy, blood transfusion within one month of laboratory testing, and lack of RDW measurement within 3 months of the RHC. Hemodynamic parameters obtained on RHC, as were hemoglobin and RDW values from the closest CBC obtained within 3 months of the RHC. Student’s t-test was used to compare RDW between patients with elevated RDW (> 14.5%) and normal RDW (≤ 14.5%). RDW was also compared between various cutoffs of RVSP. RESULTS: 342 patients were included in this study. A significantly higher RVSP was noted in the group with elevated RDW (> 14.5%, n = 130), as opposed to the group with normal RDW (≤ 14.5%, n = 212) (50.57 vs 41.39 mm Hg, p < 0.0001). Mean RDW was compared between high RVSP and non-elevated RSVP groups. When an RVSP > 35 mm Hg was used as the cutoff, there was a significant difference in RDW between the elevated (n = 233) and the normal (n = 109) groups (14.79 vs 13.82%, p < 0.0001). This held true when the cutoff was changed to an RSVP > 20 mm Hg; the elevated RSVP group (n = 336) tended to have a higher RVSP than the normal RVSP group (n = 6) (14.51 vs 12.9%, p = 0.0001). CONCLUSIONS: This study indicates a correlation between RDW and RVSP. This correlation may be a consequence of the association between RDW and mean pulmonary artery pressure (mPAP) in the setting of PH, which has been demonstrated in other previous studies. While the mechanism for this association is unknown, it is hypothesized to be a consequence of the nature of RDW to correlate to the level of inflammatory cytokines; PH is a disease with a significant inflammatory component. Alternatively, RDW may be tied to the level of subclinical hypoxia or hemolysis associated with microvascular disruption in PH. CLINICAL IMPLICATIONS: The measurement of RVSP is usually the first step in the evaluation of a patient with suspected PH. RDW, being a conveniently measured parameter on complete blood counts, appears to correlate with RVSP, and may have a role in pre-test risk stratification for PH. DISCLOSURES: No relevant relationships by Syed Haider, source=Admin input No relevant relationships by Pius Ochieng, source=Web Response No relevant relationships by Divya Ravi, source=Web Response No relevant relationships by NISHANT SHARMA, source=Web Response No relevant relationships by Metlapalli Venkata Sravanthi, source=Web Response No relevant relationships by Pandi Todhe, source=Web Response

The relationship between level of the red cell distribution width and the outcomes of patients who acquired pneumonia from community

BackgroundInflammatory and oxidative stress caused by infection has recently been proposed as a mechanism of association between the red cell distribution width (RDW) and infectious diseases, such as community-acquired pneumonia (CAP).ObjectiveThe present goal was to assess the prognostic importance of the RDW test in patients with CAP.Patients and methodsThe present research was a descriptive and prospective study of patients diagnosed with CAP. All were admitted to Chest Department of Assiut University Hospital between April 2017 and July 2018. Assessment of CAP severity at time of hospital admission using Pneumonia Severity Index was done for all enrolled patients. Complete blood count was measured by automated hematology analyzer, and RDW was reported as a part of the complete blood count result. Normal reference range of RDW was 11.5–14.5%. All of the patients were followed up until being discharged. The outcome variable was in-hospital mortality.ResultsThe current study involved 94 patients with CAP: 77 (82%) survived and 17 (18%) died. RDW level was significantly higher in nonsurvivors compared with survivors (18.52±3.07 vs. 12.76±2.08; P=0.022). A significant positive relationship was found between RDW level and Pneumonia Severity Index points (r=0.664; P=0.000). Regarding the diagnostic performance of the RDW test, it was observed that RDW level at cutoff point more than 16.1% had 94.12% sensitivity and 98.70% specificity for the prediction of inhospital mortality in patients with CAP.ConclusionThe present data indicated that the measurement of RDW on admission may provide the physician with a tool to predict the outcomes of patients with CAP and thus assist in decision making and management in such cases either alone or alongside the other well-established means, taking into account that RDW testing is simple, cheaper, and readily available.

Red Cell Distribution Width and Its Relationship with Microalbuminuria Among Patients with Essential Hypertension

Background: Elevated Red Cell Distribution Width (RDW) is an indicator of renal damage in hypertensive patients. Microalbuminuria (MAU) is an indicator of risk for cardiovascular complications and progressive renal damage in patients with diabetes and also hypertension. Objectives: 1. Determine RDW and microalbuminuria in hypertensive patients. 2. Determine RDW levels in hypertensive patients with microalbuminuria and without microalbuminuria and to evaluate the relationship between these two parameters. Methodology: Our prospective study was conducted on 98 patients attending outpatient clinic for blood pressure check up and treatment. For measurement of RDW - 2 ml blood was collected by clean venepuncture and collected in EDTA tube and determined RDW by automatic cell counter (sysmex KX-21) and for microalbuminuria - Early morning urine samples were collected and microalbumin determined by immunoturbidimetry. Statistical analysis were done using SPSS version – 16.0. Results: A total of 98 patients were included in the present study with age ranging from 30 – 86 year. All the patients were known hypertensive under treatment and 54 of them also had associated diabetes mellitus. The male to female ratio of the sample was 29:69. Out of the total 98 patients, 58 (59.2%) presented with microalbuminuria and 23 (23.5%) patients had RDW value above normal. Out of the 58 patients with microalbuminuria, 17 (29.3%) patients had RDW value above normal but only 6 (15%) patients out of 40 patients without microalbuminuria had RDW value above normal. Conclusion: Though we could not find out a direct relationship between RDW and MAU, some of the individual patients with MAU had high RDW compared to patients without MAU. As RDW is routinely done as part of complete blood counts in all patients, if its value is high in hypertensive patients, we can workup the patient for microalbuminuria. Early detection and treatment can avoid complications in these patients.

Investigation of neutrophil-to-lymphocyte ratio and red cell distribution width in sudden senseurineural hearing loss

Background: Sudden hearing loss (DHL) is a sudden sensorineural hearing loss effecting et least 3 or more frequencies more than 30 Decibel. The purpose of this study was to investigate the usefulness of the neutrophil to lymphocyte ratio (NLR) and Red Cell Distribution Width (RDW) in the first diagnosis of sudden sensorineural hearing loss (SSHL).Methods: Total 24 patients diagnosed with SSHL and 24 control patients included in the study. Serum samples were analyzed retrospectively on the initial presentation.Results: On admission, the NLR was 2.1±1.1 The mean absolute neutrophil count was 7100±400/mm3, and the mean complete lymphocyte count was 3400±1100/mm3. RDW was 11.9±0.6. Eight patients had total healing, 12 patients had partial cure, and two patients had no healing in the study. Statistically significant changes in NLR determined in the measurements between SSHL and control group (p&lt;0.05). Significant differences were not observed in hemoglobin and hematocrit values, lymphocyte counts, RDW measurements between SSHL and control group (p &lt;0.05).Conclusions: In lights of this information we recommend to screen NLR levels in SSHL patients. This may help us follow up patients recovery and if the patients recover from the disease higher level of NLR may create doubt for recurrence of the disease in risky patients.

The Value of Red Cell Distribution Width (RDW) and Trauma-Associated Severe Hemorrhage (TASH) in Predicting Hospital Mortality in Multiple Trauma Patients.

Objective: To investigate the role of red cell distribution width (RDW) in comparison with Trauma-Associated Severe Hemorrhage (TASH) system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department.Methods:This follow-up study was conducted on multiple trauma patients (age ≥ 18 years) with Injury Severity Scores (ISS) of ≥ 16, who were referred to the emergency department from March 1, 2017, to December 1, 2017. First, all patients were evaluated based on the Advanced Trauma Life Support (ATLS) guidelines, and then, their blood samples were sent for RDW measurements at baseline and 24 hours after admission. The ISS, Revised Trauma Score (RTS), and TASH were measured in the follow-ups and recorded by third-year emergency medicine residents. Hospital mortality was considered as the outcome of the study.Results:In this study, 200 out of 535 multiple trauma patients were recruited. The frequency of hospital mortality was 19 (9.5%). In the univariate analysis, there was no significant relationship between hospital mortality and RDW at baseline, RDW on the first day, and ΔRDW (RDW at baseline - RDW on the first day), unlike ISS, RTS, TASH (p=0.97, P= 0.28, and p=0.24, respectively). On the other hand, in the multivariate analysis, ISS, RTS, and TASH showed a significant relationship with hospital mortality. The greatest area under the ROC curve (AUC) was attributed to TASH and RTS systems (0.94 and 0.93, respectively). Conclusion:TASH scoring system, which was mainly designed to predict the need for massive transfusion, may be of prognostic value for hospital mortality in multiple trauma patients, similar to ISS and RTS scoring systems.

Hyperglycemia and Red Cell Distribution Width for Prediction of Mortality in Preschool Children with Community Acquired Pneumonia (CAP)

Background Community acquired pneumonia (CAP) is a major infectious cause of mortality in preschool children especially in developing countries. Red Cell Distribution Width (RDW) has been associated with poor outcomes of CAP. We aimed to determine whether admission stress hyperglycemia and RDW can predict mortality in preschool children with CAP for early identification of patients at risk of mortality. Materials and Methods This is a prospective cohort analysis of a single-center study conducted in the pediatric department and Pediatric Intensive Care Unit (PICU) of Minia Children’s University hospital, El-Minia, Egypt during the period from September 2016 to February 2017. The patients were 1-59 months old children, with community acquired pneumonia. Measurement of admission serum glucose and RDW in addition to complete blood picture was done to all participating children. Assessment of the severity of CAP was done using Pediatric Respiratory Severity Score. Results: The male gender consumes a high percentage in the Non survivors group (72.7%). The hyperglycemias patients had a statistically significant risk of developing septic shock and respiratory failure than the other groups (23.8%, p 17.4, sensitivity 90.9% and specificity 92.1%, followed by admission serum glucose at cutoff point >110 mg/dl, sensitivity 90.9%, and specificity 78.95 %. Conclusion According to the results, elevated RDW and admission hyperglycemia are reliable predictors of mortality in preschool children with community acquired pneumonia.

Evaluation of complete blood count parameters to predict endometrial cancer.

Complete blood count parameters have been introduced to be diagnostic biomarkers for many cancer-related diseases associated with inflammatory process. The aim of our study was to detect whether there is any relationship between benign or malignant endometrial pathologies and complete blood count parameters. Four hundred and sixteen patients with a complaint of abnormal uterine bleeding who admitted to Zeynep Kamil Women and Children's Health Training and Research hospital between 2013 and 2016 and undergoing endometrial biopsy were included in the study. The patients were evaluated in three groups as follows: endometrial carcinoma (n: 97), endometrial hyperplasia (n: 135), and healthy control (n: 184) groups. All patients had a complete blood count on the day of biopsy or within the week of the biopsy, and the presence of a relationship between complete blood count parameters and benign or malignant endometrial disease was investigated. Mean corpuscular volume measurements were found to be significantly higher in endometrial carcinoma (P=.018) and endometrial hyperplasia (P=.001) groups compared to the control group. While red cell distribution width measurements were found to be significantly lower in patients with endometrial carcinoma group compared to other groups (P<.01); the area under curve obtained for MPV is 58.7% to determine endometrial carcinoma. Mean corpuscular volume and red cell distribution width are bio-markers that we can use as the predictive marker in patients with endometrial carcinoma and which are cheap, repeatable, and readily obtainable from complete blood count panels and promising.

Combined Assessment of the Red Cell Distribution Width and B-type Natriuretic Peptide: A More Useful Prognostic Marker of Cardiovascular Mortality in Heart Failure Patients.

Objective An increased red cell distribution width (RDW) has been reported to be associated with adverse outcomes in patients with heart failure (HF). This study aimed to evaluate the prognostic power of the combined measurement of RDW and B-type natriuretic peptide (BNP) concentrations in patients with HF. Methods and Results We retrospectively studied 116 patients (mean age, 63.7±14.3 years) who were admitted for the treatment of HF. Data including demographic information, vital signs, and laboratory and echocardiographic measurements at admission were collected from medical records. The observational period was defined as the number of days from hospitalization, and the study endpoint was defined as cardiovascular death. The mean RDW and BNP concentration at admission were 14.5±2.0% and 626±593 pg/mL, respectively. During a median observation period of 1,046 days, 22 patients died of cardiovascular disease. A univariate Cox proportional hazard analysis revealed that both RDW [hazard ratio (HR) 1.252, p = 0.0391] and BNP (HR 1.001, p = 0.0445) were significant prognostic indices for cardiovascular death. A receiver operating characteristic curve analysis revealed that the optimal cut-off RDW and BNP values for cardiovascular death were 14.9% and 686 pg/mL, respectively. The Kaplan-Meier survival curve revealed that the survival rate of patients with both RDW ≥ 14.9% and BNP ≥ 686 pg/mL showed the poorest prognosis in comparison to the patients in the other groups. Conclusion The combined assessment of the RDW and BNP concentrations may be useful for predicting mortality in patients with HF.

Association of red cell distribution width with all-cause and cardiovascular-specific mortality in African American and white adults: a prospective cohort study

BackgroundWhile the mortality rate is declining in the United States, the life expectancy gap among different population groups suggests a need to identify biomarkers to improve early identification of individuals at risk. Red cell distribution width (RDW), a measure of anisocytosis, is an emerging biomarker of chronic disease morbidity and mortality, particularly in the elderly. However, little is known about its association with mortality risk in younger adults. The objectives of this study were to investigate the association between RDW and overall and cause-specific mortality risk, and to identify novel determinants of RDW level.MethodsWe used prospectively collected data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study conducted in Baltimore, Maryland. At baseline (2004–2009), the study recruited 3720 African American and white men and women aged 30–64 years. Participants provided peripheral venous blood for RDW measurement as part of complete blood count, and genotyping. Mortality status was ascertained using the National Death Index database through December 31, 2013. Multivariable adjusted Cox proportional hazards regression models were fitted to assess mortality risk, and multiple linear regression models to identify determinants of RDW level.ResultsParticipants’ mean age was 48.1 (9.2) years. Of 2726 participants included in the present analyses, 57% were African Americans, and 56% were women. After 18,424 person-years of follow-up time, there were 226 deaths, and the leading cause of death were cardiovascular diseases (31.9%). Participants in the highest quartile of RDW had a 1.73-fold increased all-cause mortality risk (highest quartile vs. lowest quartile, multivariable adjusted hazard ratio = 1.73, 95% confidence interval: 1.10–2.74, p-trend = 0.006). This effect was significantly modified by body mass index (p-interaction = 0.004). Similar risk was observed for cardiovascular disease-specific mortality. Independent of body mass index, waist-hip ratio and illicit drug use were significantly associated with RDW.ConclusionsElevated RDW was associated with a substantial risk of all-cause and cardiovascular disease-specific mortalities that was modified by body mass index. Central obesity and illicit drug use influence RDW level. In vulnerable populations at-risk for health disparities, RDW could provide a useful and inexpensive biomarker of mortality.

Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, Mean Platelet Volume and Red Cell Distribution Width Measures in Bells Palsy.

AIM:The purpose of this study was to investigate the usefulness of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW) in the differential diagnosis and follow-up of patients with Bells Palsy.MATERIAL AND METHODS:Twenty-eight patients diagnosed with Bells Palsy and 28 control patients were included in the study. Serum samples were analysed retrospectively on the initial presentation and the seventh day of admission.RESULTS:On admission, the NLR was 1.7±1.2. The mean absolute neutrophil count was 6100 ± 900/mm^3 in Bells Palsy Group. NLR was 0.9 ± 0.2. The mean absolute neutrophil count was 4400 ± 1100/mm^3 in control group. Statistically, significant changes were not observed in NLR, PLR, MPV and RDW measurements in Bells Palsy group between House-Brackman Staging.CONCLUSION:Statistically significant changes in the neutrophil count and NLR were determined in the measurements between Bells Palsy and control group (p = 0.013, p = 0.016 respectively) on admission. A grade of the disease and NLR measurements had no statistically significant connection. RDW value was investigated for the first time in the literature for Bells Palsy patients.

Clinical and prognostic significance of anisocytosis measured as a red cell distribution width in patients with colorectal cancer.

: colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide, and detection of new prognostic markers is mandatory for patients to receive optimal oncological treatment. The aim of the study was to assess clinical and prognostic value of red cell distribution width (RDW) in patients with CRC. : RDW values in 90 patients with CRC undergoing surgery for primary disease were analyzed in pre- and postoperative setting, and correlated with clinical and hematological parameters. : Both pre- and postoperative RDW measurements were found to be associated with features of iron deficiency anemia, inflammatory response to tumor, advanced age and depth of tumor invasion. Optimal cutoff points were calculated to be 14% for preoperative and 13.6% for postoperative RDW measurements. Elevations in both pre- and postoperative RDW values had significant effects on survival in univariate and multivariate analyses. Effects were found to be independent of tumor related features, stage of the disease, development of anemia and aberrant inflammatory response to tumor. : RDW is an integrative parameter reflecting tumor specific features and shows significant association with overall survival in patients with CRC. This is especially important in patients with stage 2 disease where elevation in preoperative RDW values can contribute to recognition of higher risk patients.

Importance of Mean Red Cell Distribution Width in Hypertensive Patients.

PurposeRed cell distribution width (RDW), expressed in femtoliters (fl), is a measure of the variation in the size of circulating erythrocytes and is often expressed as a direct measurement of the width of the distribution. We aim to observe the mean value of red cell distribution width (RDW) in hypertensive patients. Increased RDW can be used as a tool for early diagnosis, as an inflammatory marker, and a mortality indicator in hypertensive patients due to its close relation to inflammation.Materials and methodologyHypertensive patients who had the condition for more than one year duration, diagnosed according to the Joint National Committee (JNC 7) criteria were subjected to complete blood count and RDW measurement. One hundred patients, aged between 12 years and 65 years were enrolled from the outpatient department of medicine at the Military Hospital Rawalpindi.ResultsThe mean age (± SD) of the patients was 51.48 ± 10.08 years. Out of 100 patients 69% were males whereas 31% were females. The overall frequency of hypertension more than five years was 55% subjects whereas 45% individuals had duration of hypertension less than five years. Mean RDW in females was found to be 49.35±8.42 fl while mean RDW in males was 44.78±7.11 fl. An independent sample t-test was applied to assess if there was any significant difference between age and gender. No significant difference between age and gender was found (p<0.05). The Mann-Whitney test was used to assess any association of RDW with gender. RDW values in females was found to be statistically significantly higher than in males (U=603, p=0.01). Linear regression showed that mean RDW value increased with increasing age (P <0.001).ConclusionsA significant number of patients with hypertension have increased levels of RDW. Therefore, it is recommended that serum RDW should be checked regularly in patients with hypertension.