Red Cell Distribution Width Values Research Articles

A comparison of scoring systems and biomarkers to predict the severity of acute pancreatitis in patients referring to the emergency clinic.

To investigate scoring systems and biomarkers for determining the severity and prognosis of acute pancreatitis (AP). Between January and July 2023, 100 patients with AP diagnosed and treated in the emergency department were included. AP was divided into 2 groups according to severity: mild AP and moderately severe AP (MSAP-SAP), according to the revised Atlanta Classification in 2012. Demographic characteristics, severity, intensive care unit (ICU) admission, white blood cell count (WBC), hematocrit, red cell distribution width from whole blood taken at admission and 48 hours later, C-reactive protein (CRP) and biochemistry values, Bedside Index for Severity in Acute Pancreatitis (BISAP), Pancreatitis Activity Scoring System (PASS), and harmless AP score scores were recorded retrospectively. Our variables, which were found to be significant in multiple logistic regression results, were found to increase MSAP-SAP expectation by 4.36-, 7.85-, 6.63 and 5.80 times in the presence of CRP > 47.10, WBC > 13.10, PASS > 0, and necrotizing computed tomography findings, respectively. It was detected that the risk factor which was found significant as a single variable affecting the ICU admission increased the risk of ICU requirement by 28.88 when PASS > 0, by 3.96 when BISAP > 1, and it increased the Atlanta score by 9.93-fold. We found that WBC and CRP values at the time of hospital admission and WBC, CRP, and red cell distribution width values after 48 had the highest accuracy in determining AP disease severity. BISAP, which was found to be significant in determining MSAP-SAP expectations, lost its significance in multiple logistic regression results, and PASS was found to be effective. The PASS is an important score in the clinical evaluation of patients with AP and in determining the need for ICU hospitalization.

Dynamic change in red cell distribution width as a predictor for short-time mortality in dermatomyositis-associated rapid progressive interstitial lung disease

AimWe aimed to explore a new and readily available practical marker for rapidly progressive interstitial lung disease (RP-ILD) and poor short-term outcomes in patients with idiopathic inflammatory myopathies (IIM).MethodsA total...

Correlation between Red Cell Distribution Width (RDW) and Mean Corpuscular Volume (MCV) as a Prognostic Biomarker for Diabetic Nephropathy Patients in a South Indian Hospital

Context: Diabetic nephropathy is one of the microvascular complications of diabetes mellitus, capable of leading to end-stage renal disease. Diabetic nephropathy could only be identified through renal biopsy testing, which is expensive and can impose a financial burden on patients. Therefore, there is a necessity to develop a cost-effective method for identifying diabetic nephropathy. Aim: To evaluate the correlation between RBC parameters, such as RDW and MCV values, as prognostic biomarkers for patients with diabetic nephropathy. Methods and Material: Study Design: Prospective comparative study. Study Site: Sudha Institute of Medical Science, Erode. Study Duration: Study was carried out over six-months. Sample Size: 101 diabetic nephropathy patients and 101 type 2 diabetes mellitus patients. Statistical Analysis: Pearson correlation. Results: The majority of diabetic nephropathy patients were 40 years old or older, and most of them were males. Among the study participants, a significant number of male participants had habits of smoking and alcohol consumption. The duration of diabetes and BMI exhibited a strong correlation with the occurrence of diabetic nephropathy. Furthermore, there were notable increases in urea, creatinine, FBS, RBS, PPBS, and HbA1C, alongside a decrease in MCV and eGFR as diabetic nephropathy progressed. Conclusions: Our research indicates a positive correlation between RDW and HbA1c, FBS, RBS, PPBS, urea, and creatinine. In contrast, negative correlation of RDW with MCV and eGFR. MCV is negatively correlated with HbA1c, FBS, RBS, PPBS, urea, creatinine. In contrast, positive correlation between MCV and eGFR.

Prognostic value of red cell distribution width in non-ST elevation myocardial infarction: A cohort study.

Non-ST elevation myocardial infarction (NSTEMI) has a higher risk of long-term mortality than ST-elevation myocardial infarction; thus, identifying such high-risk patients is essential. Red cell distribution width (RDW) recently emerged as a strong predictor of mortality in several cardiovascular diseases, however, it is scarcely known whether RDW has a prognostic value in NSTEMI patients, therefore, this study aims to elucidate this issue. 421 consecutive patients with NSTEMI between January 2020 and June 2022 were prospectively enrolled. Patients were divided into 2 groups by the optimal cutoff value of RDW using time-dependent receiver operating characteristic curves. The optimal cutoff value of RDW for predicting all-cause mortality was 13.4 and the study population was divided into low RDW (≤13.4) and high RDW (>13.4). The primary endpoint of this study was long-term all-cause mortality. The secondary endpoint was the association between RDW and long-term adverse events, including heart failure, gastrointestinal hemorrhage, stroke events, re-infarction rate, cardiovascular mortality, and major adverse cardiovascular events. The association of RDW with the outcome was analyzed by Cox regression analysis. Patients with high RDW tended to be older, had a higher history of previous MI, a higher history of percutaneous coronary intervention, a higher level of neutrophil, high-sensitivity C-reactive protein, a lower level of albumin, and a lower level of ejection fraction (all P < .05). During a median follow-up of 720 days (IQR, 534-913 days), the all-cause mortality was significantly higher in the high RDW group than in the low RDW group (24.8% vs 6.3%, P < .001). In the multivariate Cox proportional hazard analysis, RDW > 13.4 was an independent predictor for long-term all-cause mortality [hazard ratio 3.008; 95% confidence interval 1.005, 9.003, P = .049]. Admission RDW could be used as a new biomarker for predicting long-term mortality in patients with NSTEMI, and high RDW was associated with an increased risk of all-cause mortality.

Evaluating RDW’s Role in Heart Failure Mortality: Insights and Implications

To the Editor, I am writing to express my appreciation for the recent publication by Umit Yuksek, "Red Cell Distribution Width Is an Independent Predictor of 1-Year Mortality in a Turkish Patient Population with Acute Decompensated Heart Failure" [1]. This study contributes significantly to our understanding of prognostic factors in acute heart failure, highlighting the importance of red cell distribution width (RDW) as an independent predictor of 1-year mortality in patients with acute decompensated heart failure. The methodology used in the study, which involved a cohort of 101 patients, provides an analysis of the predictive value of RDW as well as traditional clinical predictors. The finding that a 1% increase in RDW is associated with a 44% increase in 1-year mortality is particularly striking and emerging as a simple but powerful prognostic marker in clinical practice. In addition to the limitations mentioned by the author, there are a few other factors that could potentially impact the results. First, studies on the effect of demographic characteristics on the value of RDW show that RDW is associated with various clinical conditions and demographic factors [2]. It has been reported that RDW can be affected by a number of factors, such as age, gender, inflammation, coronary artery disease, heart failure, hyperlipidemia, diabetes mellitus, pneumonia, and chronic obstructive pulmonary disease. Patients with acute decompensated heart failure may also be frequently intertwined with these diseases during their initial admission. The fact that some of these important demographic characteristics were not clearly explained in the patient population of the study may be important in terms of influencing the results of the study. The criteria for inclusion or exclusion in the study are also not comprehensive and clear. We think that these should be specified in more detail. In addition, the non-invasive diagnosis of heart failure with preserved ejection fraction (HFpEF) is difficult and controversial. For this reason, it is recommended to use scoring systems like H2FPEF and HFA-PEFF for the diagnosis of HFpEF [3,4]. We believe that if any echocardiography or laboratory parameters other than the EF were evaluated while considering this patient group, it would be good to mention the methodology section. However, mentioning this issue in the limitations section may be useful if it is not mentioned. Second, when we look at the comparison of the clinical and laboratory characteristics of the subgroups with normal, high, and very high RDW values, it is noteworthy that factors such as Killip classification, mitral insufficiency, atrial fibrillation, cardiogenic shock, inotropic drug requirement, which may have significant effects on mortality in acute HEART FAILURE, do not have a significant relationship with high RDW. It also appears that even if it is not statistically significant, the EF value is positively correlated with RDW. As a result, despite this important success of RDW in showing a 1-year mortality estimate, it also has a weak relationship with many other mortality predictor parameters in acute heart failure, suggesting that unforeseen clinical conditions or parameters may potentially affect RDW in this study group. Statistically significant findings may not always be clinically or biologically significant. RDW may indicate that it is a clinically important variable, but this effect may be small and not make a significant difference in practice. The reason for coming to this conclusion is that the important limitations mentioned above may affect the study results. In conclusion, we believe that further research is necessary to investigate the mechanisms underlying the association between RDW and mortality in acute heart failure patients and to examine the potential of RDW to guide therapeutic interventions. We commend the author of this study, which not only enriches our understanding but also opens avenues for future research in acute heart failure management, and we thank the journal for publishing it. Yours sincerely

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma.

Background and Objectives. Hepatocellular carcinoma (HCC) and the intrahepatic biliary tract cancers are estimated to rank sixth for incidence among solid cancers worldwide, and third for mortality rates. A critical issue remains the need for accurate biomarkers for risk stratification and overall prognosis. The aim of this study was to investigate the ability of a biomarker of heterogeneity of the size of red blood cells, the red cell distribution width (RDW), to predict survival in patients with HCC. Materials and Methods. A consecutive series of patients with a histologic diagnosis of HCC were included into this study irrespective of their age, stage of the disease, and treatment administered, and followed-up for a period of three years. Demographic, anthropometric [age, sex, body mass index (BMI)], and clinical data (Charlson Comorbidity Index, Child-Pugh score, etc.), along with laboratory tests were retrieved from clinical records. Results. One-hundred and four patients were included in this study. Among them, 54 (69%) were deceased at the end of the follow-up. Higher RDW values, but not other hematological and biochemical parameters, were significantly associated with mortality in both univariate and multivariate analysis. The optimal RDW cut-off value identified with the Youden test for survival was 14.7%, with 65% sensitivity and 74% specificity (AUC  =  0.718, 95% CI 0.622-0.802, p  <  0.001). Kaplan-Meier survival curves showed significantly lower survival with higher RDW values (HR = 3.5204; 95% CI 1.9680-6.2975, p < 0.0001) with a mean survival of 30.9 ± 9.67 months for patients with RDW ≤ 14.7% and 22.3 ± 11.4 months for patients with RDW > 14.7%. Conclusions. The results of our study showed that RDW can perform better than other blood-based biomarkers in independently predicting prognosis in patients with HCC.

Preoperative evaluation of red blood cell distribution width as a promising biomarker for discriminating between benign and malignant breast tumors and assessing breast cancer activity.

The red cell distribution width (RDW) has been recognized as a new prognostic factor in various pathophysiological states including breast cancers. The aim of this study was to compare the RDW values between patients diagnosed with benign and malignant breast tumors and to evaluate the potential of elevated RDW as a biomarker for breast cancer activity. A cross-sectional study compared RDW values in age-matched cohorts diagnosed with benign and malignant breast lesions and correlated them with prognostic factors for malignant breast tumors. The study excluded individuals with inflammatory disorders, pre-neoplastic disease, hematological disorders, or those taking immunosuppressive or anti-inflammatory medications. The RDW values were measured using an automated hematology analyzer. The study's statistical analysis was conducted using SPSS software at a significance level of 0.05. RDW demonstrated a statistically significant elevation in the cohort of patients with malignant breast tumors, those with metastatic breast tumors, a greater number of infiltrated axillary lymph nodes, larger tumor diameter, and a higher grade of the primary tumor mass. The findings of this study suggest that RDW has the potential to serve as a biomarker for assessing breast cancer activity and could offer substantial advantages in clinical contexts. The present study is not without limitations, and the authors suggest that a larger multicenter prospective study be conducted to further validate it's efficacy over an extended duration.

Possible Correlations between Mean Platelet Volume and Biological, Electrocardiographic, and Echocardiographic Parameters in Patients with Heart Failure.

(1) Background: Despite advancements in medical research and discoveries, heart failure (HF) still represents a significant and prevalent public health challenge. It is characterized by persistently high mortality and morbidity rates, along with increased rates of readmissions, particularly among the elderly population. (2) Methods: This study was conducted retrospectively on 260 patients with stable or decompensated chronic HF. The parameter of interest in the study population was the mean platelet volume (MPV), and the main objective of the research was to identify a possible relationship between MPV and several variables-biological (NT-proBNP, presepsin, red cell distribution width (RDW)), electrocardiographic (atrial fibrillation (AFib) rhythm, sinus rhythm (SR)), and echocardiographic (left ventricle ejection fraction (LVEF), left atrial (LA) diameter, left ventricle (LV) diameter, pulmonary hypertension (PH)). (3) Results: By applying logistic and linear regression models, we assessed whether there is a correlation between MPV and biological, electrocardiographic, and echocardiographic variables in patients with HF. The results revealed linear relationships between MPV and NT pro-BNP values and between MPV and RDW values, and an increased probability for the patients to have an AFib rhythm, reduced LVEF, dilated LA, dilated LV, and PH as their MPV value increases. The results were deemed statistically relevant based on a p-value below 0.05. (4) Conclusions: Through regression model analyses, our research revealed that certain negative variables in HF patients such as increased levels of NT-proBNP, increased levels of RDW, AFib rhythm, reduced LVEF, dilated LA, dilated LV, and PH, could be predicted based on MPV values.

Detecting Iron Deficiency Anemia in Type C Hospital: Role of RDW and MCV Parameters

Iron deficiency anemia remains a global health problem, which is also a prominent cause of morbidity and mortality of all range of ages. There are three stages of anemia development, and there are some parameters to detect bodily iron status. Transferrin saturation is one of the reliable parameters. Among all hematology parameters, Red Cell Distribution Width (RDW) and Mean Corpuscular Volume (MCV) are two of the most often studied. MCV and RDW are relatively affordable and accessible, most importantly for rural areas with lower socioeconomic status. This was an analytical observational study with a cross-sectional design aimed to determine the correlation between RDW and MCV values with iron deficiency anemia, which was measured by transferrin saturation. A significant correlation was found between RDW, MCV values, and iron deficiency anemia in patients of Mitra Keluarga Cikarang Hospital and Permata Keluarga Hospital, Jakarta with a p-value of &lt;0.05. Sensitivity and specificity for MCV were 75% and 100%, for RDW were 55.45% and 80%, respectively. In conclusion, RDW and MCV parameters can be used as screening instruments for iron deficiency anemia.

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&lt;0.001). The BODE index has a median of 1 (0–3). RDW increased with the BODE index as it increased (p&lt;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&lt;14.3% and 29% for groups with RDW&gt;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.

PANKREATİTLİ ÇOCUKLARDA HEMATOLOJİK PARAMETRELERİN KLİNİK ÖNEMİ

OBJECTIVE: In this study, we aimed to retrospectively evaluate the significance of new hematological parameters in the diagnosis of the inflammatory process of acute pancreatitis in children diagnosed with acute pancreatitis (AP) and acute recurrent pancreatitis (ARP). This is the first study in the literature assessing new hematological parameters (Red cell distribution width (RDW), red cell distribution width to calcium ratio (RDWCaR), neutrophile to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), Red cell distribution width to platelet ratio (RDWPR) and mean platelet volume (MPV)) in children with pancreatitis retrospectively. MATERIAL AND METHODS: The medical records of 55 patients, who were admitted to the hospital between January 2014 and December 2019 were diagnosed with AP and ARP, were examined retrospectively. RDW, RDWCaR, MPV, NLR, LMR, RDWPR and PLR values at 0 and 48 hours were evaluated retrospectively. Group 1 consists of patients with acute pancreatitis, Group 2 consists of patients with acute recurrent pancreatitis. A p value of &amp;lt;0.05 was considered statistically significant. RESULTS: RDW48h values of Group 1 and Group 2 were found to be significantly lower than RDW0h values (p&amp;lt;0.001 and p=0.006, respectively). RDWCaR48h values in both groups were also found to be significantly lower than RDWCaR0h (p= 0.003 and p= 0.012, respectively). NLR48h value was detected to be lower than NLR0h in Group 1 (p= 0.004). Moreover, the RDWPR48h value was found to be lower compared to RDWPR0h in Group 2 (p=0.041). CONCLUSIONS: In this study, we determined that RDW, RDWCaR, NLR and RDWPR values within the first 48 hours were important in the diagnosis and follow-up of children with AP and ARP.

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

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

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

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

Evaluation of Iron Status in Children Presenting with Febrile Seizure in a Tertiary Health-care Facility

Abstract Introduction: The aim of this study was to investigate the relationship between iron deficiency anemia (IDA) and febrile seizures (FS) in children. Materials and Methods: The study included 100 cases of FS in children between the ages of 6 and 60 months, including both simple and complex FS. Children in the same age range who had a fever but no seizures made up the control group. The various hematological parameters reflecting the iron status, including hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red-cell distribution width (RDW), serum ferritin, and total iron-binding capacity (TIBC), were evaluated in both groups to ascertain the relationship between the iron status and the FS. Results: Male-female ratio in children with and without FS were 1.2:1 and 1.3:1, with a mean age of 25.16 ± 11.75 and 24.37 ± 11.75 months, respectively. Age and gender distribution were comparable between the two groups (P = 0.719 and P = 0.851, respectively). The mean values for Hb, MCV, MCHC, RDW, ferritin, and TIBC among children who had FS were 11.030.98 g/dL, 66.1810.97 fl, 32.421.38 pg/L, 14.881.13, 46.5432.64 ng/mL, and 419.7672.49 g/dL, respectively. In contrast, the readings for the control group’s children were 11.91 0.78, 67.94 11.06 fl, 32.80 0.60 pg/L, 14.16 1.01, 59.20 27.52 ng/mL, and 378.65 60.87 g/dL, respectively. Except for the mean MCV, each of these variances was statistically significant. Conclusions: Our results suggest that IDA is a major risk factor for FS since it was more common in the case group than in the control group.

Evaluation of the association between red cell distribution width (anisocytosis) and degree of liver fibrosis in children with chronic liver diseases

Summary: Background: Red cell distribution width (RDW) demonstrates the heterogeneity of red cell volume and is a component of the complete blood count. Recent studies, however, have reported that RDW is associated with increased mortality in many clinical conditions and found that high RDW is associated with an increase in all-cause mortality. Some studies have also reported the association between RDW values and the severity of liver diseases. It has been claimed that elevated RDW values positively correlate with MELD scores in different disease statuses of hepatitis B virus infection. In addition, RDW increased with the worsening of Child-Pugh grade in hepatic cirrhosis. Methods: This study investigated the clinical utility of RDW values for indicating the presence of liver fibrosis in children with chronic liver diseases. We have conducted a retrospective study on 413 patients. We collected demographic, clinical, and laboratory data and pathologic reports of the liver fibrosis stage from the medical record and analyzed them with SPSS. Result: In our study, there was no significant association between the values of RDW and different stages of fibrosis, but the association between the values of RDW and worsening of Child-Pugh score, APRI, RPR, FIB-4, and PELD score was significant. Conclusion: We cannot find any correlation between RDW and the stage of liver fibrosis. Key words: liver – RDW – fibrosis – cirrhosis

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

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

Association of serum iron and serum calcium levels in children with febrile seizures

Objectives: The current case–control study was conducted to investigate the relationship of iron deficiency anemia and calcium levels with febrile seizures (FSs) in children. Materials and Methods: The study included 200 children ranging in age from 6 to 60 months. One hundred cases had FSs, including simple FSs and rest; 100 controls had a short history of febrile illness (&lt;3 days) without seizures. A statistical analysis of the data was carried out using Statistical Package for the Social Sciences version 23. Results: The mean weight, height, and head circumference of cases and controls are 9.73 ± 2.51 kg and 10.63 ± 3.34 kg, 79.66 ± 11.08 cm and 85.43 ± 15.55 cm, and 46.37 ± 2.79 cm and 46.83 ± 3.72 cm, respectively. As per the Indian Academy of Pediatrics, 27% of cases and 37% of controls had protein energy malnutrition (PEM). In cases and controls, the mean hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width values were 9.23 ± 1.30 and 10.78 ± 1.60 gm/dL, 68.83 ± 8.86 and 78.59 ± 9.82 fl, 25.40 ± 3.47 and 28.50 ± 3.60 pg, and 18.73 ± 1.77 and 16.44 ± 1.76, respectively, and are statistically significant. Patients had lower serum ferritin levels than controls. The mean blood calcium levels in cases and controls were 9.13 ± 0.64 and 9.05 ± 0.93 mg/dL, respectively (P = 0.507). Iron deficiency anemia was found in 26% of cases and 7% of controls (P value &lt;0.001). Hypocalcemia was reported in only 18% of patients and 23% of controls (P = 0.38). Conclusion: There is a clear correlation between FSs and iron deficiency. The majority of data suggests that hypocalcemia is unlikely to be the cause of FSs. Early detection and intervention of iron deficiency in children could help in the prevention and recurrence of FSs.

Red Cell Distribution Width Is an Independent Predictor of 1-Year Mortality in a Turkish Patient Population with Acute Decompensated Heart Failure

Objective: Heart failure (HF) is a significant public health issue in Turkey. The goal of this study was to look into how red cell distribution width (RDW) affected patients with acute decompensated HF (ADHF) patients' prognoses. Methods: A total of 101 ADHF patients under the age of 18 were enrolled in the study. Venous blood was drawn to measure the serum rdw. After a year of follow-up, the patients' survival status was determined.   Results: The patients' mean age was 72. Forty-nine patients had heart failure (HF) with a reduced ejection fraction (EF), 8 had HF with a mildly reduced EF, and 44 had HF with a preserved EF. The median RDW value was 15.9%. In the hospital, nine patients passed away, and 92 others were discharged. 14 patients were lost to follow-up after one year, 87 patients completed the trial, and 40 patients passed away. Inotropic medication use, and serum RDW value were identified as independent predictors of 1-year death in ADHF patients by multivariate logistic regression analysis. According to this data, there was a 44% increase in 1-year mortality for every 1% increase in RDW. Conclusion: In Turkish patients hospitalized for ADHF, red cell distribution width represents an independent prognostic predictor for 1-year mortality.

Associations of neutrophil to lymphocyte ratio and red cell distribution width on different days with the prognosis of aneurysmal subarachnoid hemorrhage patients.

The associations of neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) with the prognosis of aneurysmal subarachnoid hemorrhage (aSAH) patients were confirmed in a few studies. But NLR and RDW levels in most of these studies were on admission. Here we carried 1 retrospective study including 150 patients with aSAH who underwent surgeries in the First Affiliated Hospital of Yangtze University from January 2020 to February 2023 to explore the associations on the preoperative day, the first (1st), third (3rd), and seventh (7th) postoperative days. The level of RDW on the 3rd postoperative day and level of NLR on the 7th postoperative day in patients with poor prognosis were significantly higher than patients with good prognosis. The results of multivariate logistic analysis also confirmed the associations of RDW on the 3rd postoperative day (OR = 16.785, 95% CI: 4.077-69.107, P < .001) and NLR on the 7th postoperative day (OR = 8.399, 95% CI: 2.167-32.544, P = .002) with prognosis of aSAH patients. The results of receiver operating characteristic curve showed that cutoff values of RDW and NLR for predicting the prognosis in aSAH patients were 13.05% and 6.97, respectively. Higher RDW on the 3rd postoperative day and NLR on the 7th postoperative day were possibly associated with poor prognosis of aSAH patients. We should pay attention to the RDW and NLR levels during different hospitalization periods, especially in the short postoperative period. Moreover, the cutoff values for predicting prognosis need to be validated in larger-sample studies.

Feasibility of using red cell distribution width for prediction of postoperative mortality in severe burn patients: an association with acute kidney injury after surgery.

Severe burns cause pathophysiological processes that result in mortality. A laboratory biomarker, red cell distribution width (RDW), is known as a predictor of mortality in critically-ill patients. We examined the association between RDW and postoperative mortality in severe burn patients. We retrospectively analyzed medical data of 731 severely burned patients who underwent surgery under general anesthesia. We evaluated whether preoperative RDW value can predict 3-month mortality after burn surgery using receiver operating characteristic (ROC) curve analysis, logistic regression, and Cox proportional-hazards regression analysis. Mortality was also analyzed according to preoperative RDW values and incidence of postoperative acute kidney injury (AKI). The 3-month mortality rate after burn surgery was 27.1% (198/731). The area under the ROC curve of preoperative RDW to predict mortality after burn surgery was 0.701 (95% confidence interval [CI], 0.667-0.734; P < 0.001) with a cut-off point of 12.9. The adjusted hazard ratio in patients with RDW > 12.9 was 1.238 (95% CI, 1.138-1.347; P < 0.001). Subgroup analysis showed that the survival rate was 88.8% for the non-AKI group with RDW ≤ 12.9 and 17.6% for the AKI group with RDW > 12.9. Preoperative RDW was considered an independent risk factor for mortality (odds ratio, 1.679; 95% CI, 1.378- 2.046; P < 0.001). Preoperative RDW may predict 3-month postoperative mortality in patients with severe burns, while preoperative RDW > 12.9 and postoperative AKI may further increase mortality after burn surgery.