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Li X, Shang H, Tang Q, Guo L, Li Z. Relationship between neutrophil lymphocyte ratio and red blood cell distribution width and respiratory failure in COPD patients. Medicine (Baltimore) 2024; 103:e38512. [PMID: 38875435 PMCID: PMC11175887 DOI: 10.1097/md.0000000000038512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
The neutrophil lymphocyte ratio (NLR) and red blood cell distribution width (RDW) have been repeatedly demonstrated to be associated with risk of severity, progression, and prognosis of chronic obstructive pulmonary disease (COPD), but data on respiratory failure (RF) in patients with COPD are very limited. This study aimed to examine the relationship between NLR and RDW and the incident RF in patients with COPD. This is a retrospective study that reviewed data by examining the hospitalization medical records to identify those who were admitted with a diagnosis of COPD. Based on whether RF occurred during index hospitalization, patients were classified as COPD group and COPD combined with RF group. Also, healthy controls of the same age and sex were enrolled in a 1:1 ratio as the COPD group. Univariate comparisons were performed between three groups to examine differences. With the COPD group as reference, multivariable logistic regression was formed to identify the relationship between NLR and RDW and RF, with adjustment for multiple covariates. There were 136 healthy controls, 136 COPD patients and 62 patients with COPD combined with RF included for analysis. There was a significant difference for eight variables, including age, WBC, neutrophil, NLR, RDW, platelet, PLR, and CRP. The Spearman test showed the significant correlation between NLR and WBC (correlation coefficient, 0.38; P = .008), NLR and RDW (correlation coefficient, 0.32; P = .013), and NLR and CRP level (correlation coefficient, 0.54; P < .001). The multivariable logistic regression showed that age (every additional 10 years) (OR, 1.785), NLR (OR, 1.716), RDW (OR, 2.266), and CRP (OR, 1.163) were independently associated with an increased risk of RF. This study demonstrated the independent associative effect of NLR and RDW with RF in patients with COPD, exhibiting the potential clinical role in evaluating the progress of COPD to RF.
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Affiliation(s)
- Xinghong Li
- Department of Respiratory and Critical Care Medicine, Hebei Chest Hospital, Shijiazhuang, China
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Meng X, Sun H, Tu X, Li W. The Predictive Role of Hematological Parameters in Hypertension. Angiology 2023:33197231190423. [PMID: 37459606 DOI: 10.1177/00033197231190423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Hypertension (HT) is a common chronic disease that often causes target-organ damage and severe complications, contributing to cardiovascular morbidity and mortality worldwide. Accumulating evidence suggests that inflammation plays a prominent role in the initiation and progression of HT. Multiple inflammatory biomarkers have been proposed to predict HT. Several new hematological parameters can reflect the inflammatory response and platelet activation. The major advantage of hematological parameters over conventional inflammatory markers is that they are relatively inexpensive and easily obtained from routine blood tests. Numerous studies have investigated several hematological parameters for their utility as predictive biomarkers for the diagnosis and prognosis of HT. Among them, the neutrophil to lymphocyte ratio (NLR), monocyte to high density lipoprotein cholesterol ratio (MHR), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and systemic immune-inflammation index (SII) have recently received attention. We searched PubMed and Embase databases (up to September 18, 2022) to assess the relationships between hematological parameters and HT. This review discusses the diagnostic and prognostic value of these hematological parameters in HT, providing an important basis for early screening, risk stratification, and optimal management of hypertensive patients.
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Affiliation(s)
- Xiangzhu Meng
- Department of Cardiology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, China
| | - Hong Sun
- Department of Intensive Care Unit, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Xiaowen Tu
- Department of Cardiology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, China
| | - Wei Li
- Department of Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Eldem I, Almekdash MH, Almadani O, Levent F, Al-Rahawan MM. Red blood cell distribution width as a potential inflammatory marker in pediatric osteomyelitis. Proc AMIA Symp 2023; 36:443-447. [PMID: 37334079 PMCID: PMC10269384 DOI: 10.1080/08998280.2023.2209921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 06/20/2023] Open
Abstract
Background Red cell distribution width (RDW) has been used in the differential diagnosis of anemia and revealed to be a potential marker of inflammation. Method We conducted a retrospective study of acute-phase reactant changes in correlation with RDW among pediatric patients with osteomyelitis. Results We identified 82 patients whose mean RDW increased on average by 1% during antibiotic therapy (mean 13.9% on admission, 95% CI 13.4-14.3, and 14.9% at the end of antibiotic therapy, 95% CI 14.5-15.4). Overall, the RDW was weakly correlated with absolute neutrophil count (r = -0.21, P = 0.001), erythrocyte sedimentation rate (r = -0.17, P = 0.007), and C-reactive protein (r = -0.21, P = 0.001). The generalized estimating equation model showed a weak negative correlation between RDW and C-reactive protein during the therapy duration (B= -0.03, P = 0.008). Conclusions The mild increase in RDW, and its weak negative correlation with other acute-phase reactants during the study course, limits its utility as a therapy response marker in pediatric osteomyelitis.
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Affiliation(s)
- Irem Eldem
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | | | - Obada Almadani
- Dr. Sulaiman Al-Habib Medical Group, Riyadh, Kingdom of Saudi Arabia
| | - Fatma Levent
- AdventHealth for Children, Department of Pediatrics, Orlando, Florida
| | - Mohamad M. Al-Rahawan
- Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas
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Sim JH, Park YS, Ha S, Kim SH, Kim JU. Association between red blood cell distribution width and mortality in patients with metastatic brain tumors: A retrospective single-center cohort study. Front Oncol 2022; 12:985263. [PMID: 36276127 PMCID: PMC9586452 DOI: 10.3389/fonc.2022.985263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/16/2022] [Indexed: 12/04/2022] Open
Abstract
Metastatic brain tumor has been associated with high mortality and poor prognosis. However, information on indicators predicting surgical prognosis in patients with brain metastases is limited. This study aimed to investigate the association between preoperative red blood cell distribution width (RDW) and mortality in patients who underwent surgery for metastatic brain tumors. This study analyzed 282 patients who underwent metastatic brain tumor surgery between August 1999 and March 2020. Patients were divided into two groups based on preoperative RDW cut-off values (<13.2 and ≥13.2). The surgical outcomes were compared between the two groups. Additionally, we performed Cox regression analysis to assess the association between preoperative RDW and 1-year and overall mortality. There were significant differences in 180-day mortality (6.2% vs. 28.7%, P<0.001), 1-year mortality (23.8% vs. 46.7%, P<0.001), and overall mortality (75.0% vs. 87.7%, P=0.012) between the two groups. In the Cox regression analysis, RDW ≥ 13.2 was significantly associated with higher 1-year mortality (adjusted hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.38–3.30; P<0.001) and overall mortality (HR, 1.44; 95% CI, 1.09–1.90; P=0.010). Preoperative RDW is strongly associated with high mortality in metastatic brain tumor surgery.
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Wang Z, Fu B, Lin Y, Wei X, Geng H, Guo W, Yuan H, Liao Y, Qin T, Li F, Wang S. Red blood cell distribution width: A severity indicator in patients with COVID-19. J Med Virol 2022; 94:2133-2138. [PMID: 35048392 PMCID: PMC9015531 DOI: 10.1002/jmv.27602] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 02/05/2023]
Abstract
Red blood cell distribution width (RDW) was frequently assessed in COVID-19 infection and reported to be associated with adverse outcomes. However, there was no consensus regarding the optimal cutoff value for RDW. Records of 98 patients with COVID-19 from the First People's Hospital of Jingzhou were reviewed. They were divided into two groups according to the cutoff value for RDW on admission by receiver operator characteristic curve analysis: ≤11.5% (n = 50) and >11.5% (n = 48). The association of RDW with the severity and outcomes of COVID-19 was analyzed. The receiver operating characteristic curve indicated that the RDW was a good discrimination factor for identifying COVID-19 severity (area under the curve = 0.728, 95% CI: 0.626-0.830, p < 0.001). Patients with RDW > 11.5% more frequently suffered from critical COVID-19 than those with RDW ≤ 11.5% (62.5% vs. 26.0%, p < 0.001). Multivariate logistic regression analysis showed RDW to be an independent predictor for critical illness due to COVID-19 (OR = 2.40, 95% CI: 1.27-4.55, p = 0.007). A similar result was obtained when we included RDW > 11.5% into another model instead of RDW as a continuous variable (OR = 5.41, 95% CI: 1.53-19.10, p = 0.009). RDW, as an inexpensive and routinely measured parameter, showed promise as a predictor for critical illness in patients with COVID-19 infection. RDW > 11.5% could be the optimal cutoff to discriminate critical COVID-19 infection.
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Affiliation(s)
- Zhong‐hua Wang
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Bing‐qi Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Shantou University Medical CollegeShantouChina
| | - Ying‐wen Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Shantou University Medical CollegeShantouChina
| | - Xue‐biao Wei
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Heng Geng
- Department of Critical Care MedicineThe First People's Hospital of JingzhouJingzhouChina
| | - Wei‐xin Guo
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Hui‐qing Yuan
- Department of Respiratory and Critical Care MedicineThe First People's Hospital of ShaoguanShaoguanChina
| | - You‐wan Liao
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Tie‐he Qin
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Fei Li
- Emergency CenterThe First Affiliated Hospital of Yangtze UniversityJingzhouChina
| | - Shou‐hong Wang
- Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
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Rahmiyanti L, Rasyid H, Taslim NA, As’ad S, Bukhari A, Aminuddin A. Nutritional Status Associated to Red Cell Distribution Width, Length of Stay, and Clinical Outcome patient with Chronic Kidney Diseases. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION: Red cell distribution width (RDW) shows the heterogeneity of erythrocyte size associated with inflammation and various clinical conditions including in patients with chronic kidney disease (CKD). Systemic inflammation and oxidative stress were commonly found in CKD patients.
AIM: This study aimed to examine the relationship of nutritional status, length of hospital stay (LOS), and clinical outcome to RDW in CKD patients.
METHODS: We conducted a retrospective cohort study of 1736 patients CKD patients who admitted from January 2017 to August 2020, aged between 18 and 60 years and were hospitalized at Wahidin General Hospital. From those, 239 were consulted with clinical nutrition specialist, of which 59 patients eligible with the criteria inclusion. Data were collected through medical records and through electronic data (biochemical data). RDW was categorized into normal and high RDW group, nutritional status based on subjective global assessment (SGA), LOS <10 days and clinical outcome based on conditions at the time of hospital discharged. Data were analyzed using SPSS version 25.0.
RESULTS: The data of 59 patients were analyzed, the mean age was 50.42 years (normal RDW) and 47.24 years (high RDW), most of them are women (57.7% vs. 60.6%). There were 42 patients with moderate malnutrition (23 normal RDW and 19 high RDW) and 17 patients with severe malnutrition (3 normal RDW and 14 with high RDW). The study found a significant differences between normal RDW and high RDW (p 0.021), but not significant differences in LOS (p 0.890) and clinical outcome (p 0.968). There were a significant differences in the levels of hemoglobin (p = 0.001), RBG (p = 0.030), and serum sodium level (p = 0.010). Patient with LOS < 10 days had lower sodium levels and more severe anemia when compared with LOS > 10 days and the poor clinical outcome had a heavier degree of anemia compared to the good clinical outcomes.
CONCLUSION: Poor nutritional status was associated with an increase in RDW, degree of anemia, and sodium level.
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Hidalgo D, Bejder J, Pop R, Gellatly K, Hwang Y, Maxwell Scalf S, Eastman AE, Chen JJ, Zhu LJ, Heuberger JAAC, Guo S, Koury MJ, Nordsborg NB, Socolovsky M. EpoR stimulates rapid cycling and larger red cells during mouse and human erythropoiesis. Nat Commun 2021; 12:7334. [PMID: 34921133 PMCID: PMC8683474 DOI: 10.1038/s41467-021-27562-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/19/2021] [Indexed: 11/08/2022] Open
Abstract
The erythroid terminal differentiation program couples sequential cell divisions with progressive reductions in cell size. The erythropoietin receptor (EpoR) is essential for erythroblast survival, but its other functions are not well characterized. Here we use Epor-/- mouse erythroblasts endowed with survival signaling to identify novel non-redundant EpoR functions. We find that, paradoxically, EpoR signaling increases red cell size while also increasing the number and speed of erythroblast cell cycles. EpoR-regulation of cell size is independent of established red cell size regulation by iron. High erythropoietin (Epo) increases red cell size in wild-type mice and in human volunteers. The increase in mean corpuscular volume (MCV) outlasts the duration of Epo treatment and is not the result of increased reticulocyte number. Our work shows that EpoR signaling alters the relationship between cycling and cell size. Further, diagnostic interpretations of increased MCV should now include high Epo levels and hypoxic stress.
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Affiliation(s)
- Daniel Hidalgo
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Jacob Bejder
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ramona Pop
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Harvard Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Kyle Gellatly
- Program in Bioinformatics and Computational Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Yung Hwang
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - S Maxwell Scalf
- Department of Cell Biology and Yale Stem Cell Center, Yale University, New Haven, CT, USA
| | - Anna E Eastman
- Department of Cell Biology and Yale Stem Cell Center, Yale University, New Haven, CT, USA
| | - Jane-Jane Chen
- Institute for Medical Engineering & Science, MIT, Cambridge, MA, USA
| | - Lihua Julie Zhu
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Program in Bioinformatics and Computational Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Shangqin Guo
- Department of Cell Biology and Yale Stem Cell Center, Yale University, New Haven, CT, USA
| | - Mark J Koury
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Merav Socolovsky
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
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Abdelaleem NA, Makhlouf HA, Nagiub EM, Bayoumi HA. Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2021. [PMCID: PMC7971396 DOI: 10.1186/s43168-021-00062-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Ventilator-associated pneumonia (VAP) is the most common nosocomial infection. Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are prognostic factors to mortality in different diseases. The aim of this study is to evaluate prognostic efficiency RDW, NLR, and the Sequential Organ Failure Assessment (SOFA) score for mortality prediction in respiratory patients with VAP. Results One hundred thirty-six patients mechanically ventilated and developed VAP were included. Clinical characteristics and SOFA score on the day of admission and at diagnosis of VAP, RDW, and NLR were assessed and correlated to mortality. The average age of patients was 58.80 ± 10.53. These variables had a good diagnostic performance for mortality prediction AUC 0.811 for SOFA at diagnosis of VAP, 0.777 for RDW, 0.728 for NLR, and 0.840 for combined of NLR and RDW. The combination of the three parameters demonstrated excellent diagnostic performance (AUC 0.889). A positive correlation was found between SOFA at diagnosis of VAP and RDW (r = 0.446, P < 0.000) and with NLR (r = 0.220, P < 0.010). Conclusions NLR and RDW are non-specific inflammatory markers that could be calculated quickly and easily via routine hemogram examination. These markers have comparable prognostic accuracy to severity scores. Consequently, RDW and NLR are simple, yet promising markers for ICU physicians in monitoring the clinical course, assessment of organ dysfunction, and predicting mortality in mechanically ventilated patients. Therefore, this study recommends the use of blood biomarkers with the one of the simplest ICU score (SOFA score) in the rapid diagnosis of critical patients as a daily works in ICU.
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Murphy D, Orgel E, Koek W, Frei-Jones M, Denton C, Kamat D. A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777). J Pediatr Intensive Care 2021. [DOI: 10.1055/s-0041-1735876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractRed cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.
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Affiliation(s)
- Devin Murphy
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
| | - Etan Orgel
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Los Angeles, California, United Sates
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, California, United Sates
| | - Wouter Koek
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
| | - Melissa Frei-Jones
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
- Department of Pediatrics, Pediatric Hematology–Oncology, Long School of Medicine, University of Texas Health Science Center San Antonio, Texas, United Sates
| | - Christopher Denton
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Los Angeles, California, United Sates
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, California, United Sates
| | - Deepak Kamat
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
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Gürün Kaya A, Özyürek BA, Şahin Özdemirel T, Öz M, Erdoğan Y. Prognostic Significance of Red Cell Distribution Width in Idiopathic Pulmonary Fibrosis and Combined Pulmonary Fibrosis Emphysema. Med Princ Pract 2021; 30:154-159. [PMID: 32841950 PMCID: PMC8114038 DOI: 10.1159/000511106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/24/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The red cell distribution width (RDW) is an inexpensive, readily available prognostic indicator of several diseases. RDW has been assessed as a prognostic biomarker in patients with idiopathic pulmonary fibrosis (IPF) in only one study; furthermore, the relationship between the RDW and combined pulmonary fibrosis emphysema (CPFE) has yet to be reported. SUBJECTS AND METHODS This single-center study was conducted between January 2015 and December 2018 in the Atatürk Chest Diseases and Chest Surgery Education and Research Hospital. Baseline characteristics, laboratory results, and survival status of patients were recorded. RESULTS The RDW value was significantly higher in the CPFE group than in the IPF group (median [IQR 25-75]; 16.8 [15.5-19] vs. 15.3 [13.7-16.8], p = 0.028). High RDW values were correlated with carbon monoxide diffusion capacity (DLCO) (r: -0.653 p = 0.001), 6-minute walking test (6MWT) distance (r: -0.361 p = 0.017), arterial partial oxygen pressure (PaO2) (r: -0.692 p < 0.001), and systolic pulmonary arterial pressure (SPAP) (r: 0.349 p = 0.022) in patients with fibrotic lung disease. The RDW value was significantly higher in the exitus group than in the survivors (median [IQR 25-75]; 18.4 [15.4-19] vs. 15.2 [13.5-17.2], p = 0.016). A univariate Cox regression analysis identified DLCO, SPAP, PaO2, and RDW as potential covariates of mortality. In a multivariate analysis, the DLCO (HR 1.21, 95% CI 1.11-1.47, p = 0.012) and RDW level (HR 1.65, 95% CI 1.09-2.47, p = 0.023) remained independent predictors of mortality. CONCLUSION High RDW values appear to be a simple prognostic factor in patients with IPF or CPFE.
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Affiliation(s)
- Aslıhan Gürün Kaya
- Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey,
| | - Berna Akıncı Özyürek
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Tuğçe Şahin Özdemirel
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Miraç Öz
- Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Yurdanur Erdoğan
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
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Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients. Sci Rep 2020; 10:21185. [PMID: 33273655 PMCID: PMC7713121 DOI: 10.1038/s41598-020-78321-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/20/2020] [Indexed: 12/26/2022] Open
Abstract
The red cell distribution width (RDW) has been reported to be positively correlated with short-term mortality of pulmonary disease in adults. However, it is not clear whether RDW was associated with the long-term prognosis for acute respiratory failure (ARF). Thus, an analysis was conducted to evaluate the association between RDW and 3-year mortality of patients by the Cox regression analysis, generalized additives models, subgroup analysis and Kaplan–Meier analysis. A total of 2999 patients who were first admitted to hospital with ARF were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). The Cox regression analysis showed that the high RDW was associated with 3-year mortality (HR 1.10, 95% CI 1.07, 1.12, P < 0.0001) after adjusting for age, gender, ethnicity and even co-morbid conditions. The ROC curve illustrated the AUC of RDW was 0.651 (95% CI 0.631, 0.670) for prediction of 3-year mortality. Therefore, there is an association between the RDW and survival time of 3 years follow-up, particularly a high RDW on admission was associated with an increased risk of long-term mortality in patients with ARF. RDW may provide an alternative indicator to predict the prognosis and disease progression and more it is easy to get.
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Kim DH, Ha EJ, Park SJ, Jhang WK. Evaluation of the usefulness of red blood cell distribution width in critically ill pediatric patients. Medicine (Baltimore) 2020; 99:e22075. [PMID: 32899077 PMCID: PMC7478568 DOI: 10.1097/md.0000000000022075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Red blood cell distribution width (RDW) is a component of routine complete blood count, which reflects variability in the size of circulating erythrocytes. Recently, there have been many reports about RDW as a strong prognostic marker in various disease conditions in the adult population. However, only a few studies have been performed in children. This study aimed to investigate the association between RDW and pediatric intensive care unit (PICU) mortality in critically ill children. This study includes 960 patients admitted to the PICU from November 2012 to May 2018. We evaluated the associations between RDW and clinical parameters including PICU mortality outcomes. The median age of the study population was 15.5 (interquartile range, 4.8-54.5) months. The mean RDW was 15.6% ± 3.3%. The overall PICU mortality was 8.8%. As we categorized patients into 3 groups with respect to RDW values (Group 1: ≤14.5%; Group 2: 14.5%-16.5%; and Group 3: >16.5%) and compared clinical parameters, the higher RDW groups (Groups 2 and 3) showed more use of vasoactive-inotropic drugs, mechanical ventilator support, higher severity scores, including pediatric risk of mortality III, pediatric sequential organ failure assessment, pediatric logistic organ dysfunction-2 (PELOD-2), and pediatric multiple organ dysfunction syndrome scores, and higher PICU mortality than the lower RDW group (Group 1) (P < .05). Based on multivariate logistic regression analysis adjusted for age and sex, higher RDW value (≥14.5%) was an independent risk factor of PICU mortality. Moreover, adding RDW improved the performance of the PELOD-2 score in predicting PICU mortality (category-free net reclassification index 0.357, 95% confidence interval 0.153-0.562, P = .001). In conclusion, higher RDW value was significantly associated with worse clinical parameters including PICU mortality. RDW was an independent risk factor of PICU mortality and the addition of RDW significantly improved the performance of PELOD-2 score in predicting PICU mortality. Thus, RDW could be a promising prognostic factor with advantages of simple and easy measurement in critically ill pediatric patients.
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Gong J, Ou J, Qiu X, Jie Y, Chen Y, Yuan L, Cao J, Tan M, Xu W, Zheng F, Shi Y, Hu B. A Tool for Early Prediction of Severe Coronavirus Disease 2019 (COVID-19): A Multicenter Study Using the Risk Nomogram in Wuhan and Guangdong, China. Clin Infect Dis 2020; 71:833-840. [PMID: 32296824 PMCID: PMC7184338 DOI: 10.1093/cid/ciaa443] [Citation(s) in RCA: 318] [Impact Index Per Article: 79.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Because there is no reliable risk stratification tool for severe coronavirus disease 2019 (COVID-19) patients at admission, we aimed to construct an effective model for early identification of cases at high risk of progression to severe COVID-19. METHODS In this retrospective multicenter study, 372 hospitalized patients with nonsevere COVID-19 were followed for > 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and those who maintained a nonsevere state were assigned to the severe and nonsevere groups, respectively. Based on baseline data of the 2 groups, we constructed a risk prediction nomogram for severe COVID-19 and evaluated its performance. RESULTS The training cohort consisted of 189 patients, and the 2 independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.4%) patients developed severe COVID-19. Older age; higher serum lactate dehydrogenase, C-reactive protein, coefficient of variation of red blood cell distribution width, blood urea nitrogen, and direct bilirubin; and lower albumin were associated with severe COVID-19. We generated the nomogram for early identifying severe COVID-19 in the training cohort (area under the curve [AUC], 0.912 [95% confidence interval {CI}, .846-.978]; sensitivity 85.7%, specificity 87.6%) and the validation cohort (AUC, 0.853 [95% CI, .790-.916]; sensitivity 77.5%, specificity 78.4%). The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analyses indicated that nomogram conferred high clinical net benefit. CONCLUSIONS Our nomogram could help clinicians with early identification of patients who will progress to severe COVID-19, which will enable better centralized management and early treatment of severe disease.
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Affiliation(s)
- Jiao Gong
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jingyi Ou
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Xueping Qiu
- Center for Gene Diagnosis, Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yusheng Jie
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.,Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, People's Republic of China
| | - Yaqiong Chen
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Lianxiong Yuan
- Department of Science and Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jing Cao
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Mingkai Tan
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Wenxiong Xu
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Fang Zheng
- Center for Gene Diagnosis, Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yaling Shi
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Bo Hu
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
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Gong J, Ou J, Qiu X, Jie Y, Chen Y, Yuan L, Cao J, Tan M, Xu W, Zheng F, Shi Y, Hu B. A Tool for Early Prediction of Severe Coronavirus Disease 2019 (COVID-19): A Multicenter Study Using the Risk Nomogram in Wuhan and Guangdong, China. Clin Infect Dis 2020. [PMID: 32296824 DOI: 10.1101/2020.03.17.20037515] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Because there is no reliable risk stratification tool for severe coronavirus disease 2019 (COVID-19) patients at admission, we aimed to construct an effective model for early identification of cases at high risk of progression to severe COVID-19. METHODS In this retrospective multicenter study, 372 hospitalized patients with nonsevere COVID-19 were followed for > 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and those who maintained a nonsevere state were assigned to the severe and nonsevere groups, respectively. Based on baseline data of the 2 groups, we constructed a risk prediction nomogram for severe COVID-19 and evaluated its performance. RESULTS The training cohort consisted of 189 patients, and the 2 independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.4%) patients developed severe COVID-19. Older age; higher serum lactate dehydrogenase, C-reactive protein, coefficient of variation of red blood cell distribution width, blood urea nitrogen, and direct bilirubin; and lower albumin were associated with severe COVID-19. We generated the nomogram for early identifying severe COVID-19 in the training cohort (area under the curve [AUC], 0.912 [95% confidence interval {CI}, .846-.978]; sensitivity 85.7%, specificity 87.6%) and the validation cohort (AUC, 0.853 [95% CI, .790-.916]; sensitivity 77.5%, specificity 78.4%). The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analyses indicated that nomogram conferred high clinical net benefit. CONCLUSIONS Our nomogram could help clinicians with early identification of patients who will progress to severe COVID-19, which will enable better centralized management and early treatment of severe disease.
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Affiliation(s)
- Jiao Gong
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jingyi Ou
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Xueping Qiu
- Center for Gene Diagnosis, Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yusheng Jie
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, People's Republic of China
| | - Yaqiong Chen
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Lianxiong Yuan
- Department of Science and Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jing Cao
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Mingkai Tan
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Wenxiong Xu
- Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Fang Zheng
- Center for Gene Diagnosis, Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yaling Shi
- Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Bo Hu
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
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Yu XS, Chen ZQ, Hu YF, Chen JX, Xu WW, Shu J, Pan JY. Red blood cell distribution width is associated with mortality risk in patients with acute respiratory distress syndrome based on the Berlin definition: A propensity score matched cohort study. Heart Lung 2020; 49:641-645. [PMID: 32434701 DOI: 10.1016/j.hrtlng.2020.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Acute respiratory distress syndrome (ARDS) is a severe inflammatory disorder of the lungs and is associated with oxidative damage. However, red blood cell distribution width (RDW), as an indicator of body response to inflammation and oxidative stress, has not been studied for its relationship with ARDS as diagnosed by the Berlin definition. OBJECTIVES To examine the value of RDW in predicting the prognosis of in patients with ARDS. METHODS This is a retrospective study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Berlin-defined ARDS patients using mechanical ventilation for more than 48 hours were selected using structured query language. The primary statistical methods were propensity score matching and sensitivity analysis, including an inverse probability weighting model to ensure the robustness of our findings. RESULTS A total of 529 intensive care unit (ICU) patients with ARDS according to the Berlin definition were enrolled in the study. The adjusted OR showed an adverse effect between the higher RDW group and 30-day mortality [OR 2.33, 95% CI (1.15-4.75), P=0.019]. However, we found that length of ICU stay was not related to RDW (P=0.167), and in the anaemia group, RDW was poorly predictive of 30-day mortality (P=0.307). CONCLUSION In unselected ARDS patients, higher RDW was associated with higher 30-day mortality rate. Further investigation is required to validate this relationship with prospectively collected data.
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Affiliation(s)
- Xue-Shu Yu
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Zhi-Qiang Chen
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Yu-Feng Hu
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Jia-Xiu Chen
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Wen-Wei Xu
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Jie Shu
- Department of Intensive Care, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Jing-Ye Pan
- Department of Intensive Care, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325000, China.
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Budi Hartawan IN, Sukewanti N, Wati D, Gede Suparyatha I, Ryalino C. Correlation of red cell distribution width and serum lactate levels in critically ill pediatric patients. BALI JOURNAL OF ANESTHESIOLOGY 2020. [DOI: 10.4103/bjoa.bjoa_28_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Ryalino C, Budi Hartawan IN, Saputra Y. Correlation of red cell distribution width value with the duration of mechanical ventilator usage in patients treated in pediatric intensive care unit. BALI JOURNAL OF ANESTHESIOLOGY 2020. [DOI: 10.4103/bjoa.bjoa_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Fogagnolo A, Spadaro S, Taccone FS, Ragazzi R, Romanello A, Fanni A, Marangoni E, Franchi F, Scolletta S, Volta CA. The prognostic role of red blood cell distribution width in transfused and non-transfused critically ill patients. Minerva Anestesiol 2019; 85:1159-1167. [DOI: 10.23736/s0375-9393.19.13522-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Korkmaz MF, Tutanç M, Bostancı M, Korkmaz M, Salihoğlu TE. Red blood cell distribution width as a useful marker for severity in pediatric acute gastroenteritis. Pediatr Int 2019; 61:1109-1113. [PMID: 31529745 DOI: 10.1111/ped.14010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/21/2019] [Accepted: 09/13/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Acute gastroenteritis (AGE) in children is still one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of acute gastroenteritis. Red cell distribution width (RDW) is thought to have the potential for AGE evaluation in children. We sought to investigate the value of RDW for severity assessment in children with AGE. METHODS A total of 97 AGE patients were included in a prospective observational study. Complete blood count, serum C-reactive protein, and stool examinations were carried out. Modified Vesikari score (MVS) was evaluated to determine severity. RESULTS Median age was 19 months (min-max, 1-198 months). The male/female ratio was 1.55 (59/38). Rotavirus was detected in 31 of 97 children (32%). median MVS was 9 points (min-max, 5-24 points). A total of 32 (33%), 43 (44%) and 22 patients (23%) were classified in the mild-, moderate-, and high-severity groups, respectively. There were no significant differences between rotavirus-positive and rotavirus-negative children. Hemoglobin, mean corpuscular volume, and RDW differed significantly according to severity. RDW had the highest area under the curve when the high-severity group was compared with the combination of low- and moderate-severity groups on receiver operating characteristic analysis. CONCLUSIONS Red cell distribution width increased with the increase in severity of AGE. RDW may offer additional severity stratification in children with AGE.
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Affiliation(s)
- Muhammet Furkan Korkmaz
- Department of Pediatrics, Yüksek İhtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Murat Tutanç
- Department of Pediatrics, Yüksek İhtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Muharrem Bostancı
- Department of Pediatrics, Yüksek İhtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Merve Korkmaz
- Department of Pediatrics, Dörtçelik Children's Hospital, Bursa, Turkey
| | - Tuna Ercan Salihoğlu
- Department of Pediatrics, Yüksek İhtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
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Li G, Jia P, Zhao J, Wu X, Duan Y, Liu D, Wang T, Liu B. Usefulness of RBC distribution width and C-reactive protein to predict mortality in pediatric non-cardiac critical illness. Am J Emerg Med 2019; 37:2143-2150. [PMID: 30772131 DOI: 10.1016/j.ajem.2019.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION We aimed to assess the performance of red blood cell distribution width (RDW), C-reactive protein (CRP) or the combination of both to predict clinical outcomes in pediatric non-cardiovascular critical illness. MATERIALS AND METHODS We analyzed 404 pediatric non-cardiovascular critically ill patients admitted to pediatric intensive care unit (PICU). Potential predictors were identified using multivariable logistic regression. We also calculated the power of RDW and CRP additive to pediatric critical illness score (PCIS) to predict mortality with calculation of C-index value, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. RESULTS RDW and CRP independently predicted PICU mortality. The C-index value of PCIS with respect to prediction of PICU mortality was greater than that of RDW and CRP. The combination of RDW or CRP or both with PCIS did significantly increase C-index value for predicting mortality (all p < 0.01). Addition of RDW or CRP or their combination to PCIS provided IDI of 7%, 1.1% and 9.4% (p = 0.009, 0.01 and 0.003) and NRI of 15.9%, 13.1% and 19.6% (p = 0.002, 0.043 and 0.002), respectively. CONCLUSIONS In pediatric non-cardiovascular critically ill patients, RDW and CRP could serve as independent predictors of PICU mortality and addition of RDW or CRP or both to PCIS significantly improves the ability to predict PICU mortality.
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Affiliation(s)
- Gang Li
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Peng Jia
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Jian Zhao
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Xingdan Wu
- Department of Cardiology, Chengdu Women's & Children's Central Hospital, No. 1617, Section 1, Riyue Ave, Chengdu, Sichuan, China
| | - Yan Duan
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Dong Liu
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Ting Wang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China
| | - Bin Liu
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China.
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Usefulness of Red Cell Width Distribution (RDW) in the Assessment of Children with Pulmonary Arterial Hypertension (PAH). Pediatr Cardiol 2019; 40:820-826. [PMID: 30830279 PMCID: PMC6451723 DOI: 10.1007/s00246-019-02077-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 02/23/2019] [Indexed: 11/24/2022]
Abstract
Red cell width distribution (RDW) is known to be a prognostic marker in adults with pulmonary hypertension. The value of this test in the pulmonary arterial hypertension (PAH) pediatric population was not yet established. The aim of the study was to evaluate the prognostic value of RDW in children with PAH and utility of this parameter in the management. Data were collected retrospectively in 61 patients with PAH confirmed by right heart catheterization. RDW was measured at diagnosis, 3 and 12 months after initial therapy, during and after deterioration if occurred. Results were compared with NTproBNP, WHO-FC and oxygen blood saturation. Mean RDW at baseline was 15.3 ± 2.4% (12.1-24.4, median 14.7%) and was elevated in 29 patients (47%). There were no significant difference in clinical status, NTproBNP and hemodynamic parameters among patient with normal and elevated RDW at diagnosis. Poor negative correlation with SaO2 and SvO2 was shown. After 3 and 12 months of treatment no significant change of RDW level was found despite of statistically significant improvement of WHO-FC and decrease of NTproBNP level (NS). Episodes of clinical deterioration weren't connected with change of RDW level (16 vs. 15.6% NS). Kaplan-Meier analysis did not show differences in prognosis between patients with normal and elevated RDW. Elevation of RDW was not associated with any measured parameters. Prognostic value of RDW in the pediatric PAH population was not confirmed. Usefulness of RDW in management in PAH pediatric population is limited and required further studies.
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Spadaro S, Taccone FS, Fogagnolo A, Franchi F, Scolletta S, Ragazzi R, Fanni A, Marangoni E, Govoni M, Reverberi R, Volta CA. The effects of blood transfusion on red blood cell distribution width in critically ill patients: a pilot study. Transfusion 2018; 58:1863-1869. [DOI: 10.1111/trf.14759] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/02/2018] [Accepted: 03/06/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Savino Spadaro
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
| | - Fabio Silvio Taccone
- Department of Intensive Care; Erasme Hospital, Université Libre de Bruxelles; Brussels Belgium
| | - Alberto Fogagnolo
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
| | - Federico Franchi
- Department of Medical Biotechnologies, Anesthesiology and Intensive Care; University Hospital of Siena; Siena Italy
| | - Sabino Scolletta
- Department of Medical Biotechnologies, Anesthesiology and Intensive Care; University Hospital of Siena; Siena Italy
| | - Riccardo Ragazzi
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
| | - Alberto Fanni
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
| | - Elisabetta Marangoni
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
| | - Maurizio Govoni
- Blood Transfusion Service, Sant'Anna Hospital; Ferrara Italy
| | | | - Carlo Alberto Volta
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale; Unità Operativa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S.Anna, Università di Ferrara; Ferrara Italy
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