Role of Platelet to Lymphocyte Ratio and Red Cell Distribution Width in Predicting Postoperative Complications in Patients with Acute Mesenteric Ischemia

BACKGROUND

The predictive values of the platelet to lymphocyte ratio (PLR) and red cell distribution width (RDW) have been demonstrated in different types of abdominal surgery. The aim of this study was to investigate the interest of the preoperative PLR and RDW as predictors of 30-day postoperative complications in patients with acute mesenteric ischemia (AMI).

METHODS

Clinical data of 105 AMI patients were retrospectively reviewed. Postoperative complications were evaluated by the Clavien-Dindo classification. The cutoff values for neutrophil to lymphocyte ratio (NLR), PLR, and RDW were determined by receiver operating characteristic curves. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed.

RESULTS

In the univariate analyses, advanced age, female, anemia, high white blood cell (WBC), high PLR, high NLR, high RDW, Charlson comorbidity index (CCI) score ≥2, and bowel resection were associated with the postoperative complications. A multivariable analysis revealed that advanced age, high PLR, high RDW, and bowel resection were independent predictors of postoperative complications.

CONCLUSIONS

The PLR and RDW might play important roles in evaluation of the risk of postoperative complications in AMI patients. The preoperative PLR and RDW are simple and useful predictors of postoperative complications in AMI patients.

Can red cell distribution width in very low birth weight infants predict bronchopulmonary dysplasia?

Red cell distribution width (RDW) is a useful marker for assessing the severity and prognosis of various diseases in adults. However, whether it is applicable to children, especially in newborns, has not been determined.This study aimed to investigate the RDW values of preterm infants and evaluate whether RDW values in the early days of life can predict bronchopulmonary dysplasia (BPD) development.One hundred and eight infants born at <30 weeks of gestation with a birth weight of <1500 g participated in this retrospective study. RDW values measured at birth, 7 days (D7), and 28 days (D28) after birth were reviewed. The changes in RDW values in the first month of life were analyzed, and we evaluated the relationship between RDW and BPD.The mean RDW values at birth, D7, D28 and the change from birth to D7 were 16.2 ± 0.1%, 17.5 ± 0.2%, 17.6 ± 0.2% and 1.3 ± 1.8%, respectively. RDW at birth was lower in the infants born at <28 weeks' gestational age than in those born at ≥28 weeks' gestational age (15.7 ± 0.3 vs 16.4 ± 0.2, P = .024). RDW values of both groups increased during the first week after birth and did not differ significantly at D7. The levels remained similar at 1 month of age. RDW at birth, D7, and D28 and the changes in RDW from birth to D7 were not correlated with the development of BPD independent of its severity.The usefulness of RDW as a predictor of BPD development remains questionable and requires further study.

Red blood cell distribution width as a prognostic biomarker for viral infections: prospects and challenges

Viral diseases remain a significant global health threat, and therefore prioritization of limited healthcare resources is required to effectively manage dangerous viral disease outbreaks. In a pandemic of a newly emerged virus that is yet to be well understood, a noninvasive host-derived prognostic biomarker is invaluable for risk prediction. Red blood cell distribution width (RDW), an index of red blood cell size disorder (anisocytosis), is a potential predictive biomarker for severity of many diseases. In view of the need to prioritize resources during response to outbreaks, this review highlights the prospects and challenges of RDW as a prognostic biomarker for viral infections, with a focus on hepatitis and COVID-19, and provides an outlook to improve the prognostic performance of RDW for risk prediction in viral diseases.

A Retrospective Cohort Study on the Association between Red Cell Distribution Width and All-Cause Mortality of Patients with Cholecystitis at ICU Admission

Background

Elevated red cell distribution width (RDW) has been reported to be associated with mortality in some critically ill patient populations. The aim of this article is to investigate the relationship between RDW and in-hospital mortality and short- and long-term mortality of patients with cholecystitis.

Method

We conducted a retrospective cohort study in which data from all 702 patients extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database were used. Receiver operating characteristic (ROC) curves were constructed to evaluate the prognostic predictive value of RDW for in-hospital mortality and short- (i.e., 30-day and 90-day) and long-term (i.e., 180-day, 1-year, 3-year, and 5-year) mortality. We converted RDW into a categorical variable according to quintiles as less than or equal to 13.9%, 14.0-14.8%, 14.9-15.8%, and 15.9-17.2% and more than 17.2%. The Kaplan-Meier (K-M) methods and log-rank tests were used to compare survival differences among different groups. The relationships between RDW levels and in-hospital mortality were evaluated by univariate and multivariate binary logistic regression models. Multivariable Cox regression models were built to investigate the association of RDW on the short-term and long-term mortality.

Result

After adjusting for potential confounders, RDW was positively associated with in-hospital mortality (OR: 1.187, 95% CI [1.049, 1.343]) and short- (i.e., 30-day: HR: 1.183, 95% CI [1.080, 1.295], 90-day: HR: 1.175, 95% CI [1.089, 1.268]) and long-term (i.e., 1-year: HR:1.162, 95% CI [1.089, 1.240]) mortality in critically ill patients with cholecystitis. Similar results were also shown in the secondary outcomes of 180-day, 3-year, and 5-year mortality. RDW had a significant accurate prognostic effect on different endpoints and could improve the prognostic effect of scoring systems.

Conclusion

High level of RDW is associated with an increased risk of in-hospital mortality and short- and long-term mortality in critically ill patients with cholecystitis. RDW can independently predict the prognosis of patients with cholecystitis.

Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients

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.