RDW at Admission as a Prognostic Factor in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

International Journal of Medical Science

© 2022 by SSRG - IJMS Journal

Volume 9 Issue 2

Year of Publication : 2022

Authors : Wael Obaidtaha, Malek Hejazie, Firas Hussein

10.14445/23939117/IJMS-V9I2P102

How to Cite?

Wael Obaidtaha, Malek Hejazie, Firas Hussein, "RDW at Admission as a Prognostic Factor in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease," SSRG International Journal of Medical Science, vol. 9,  no. 2, pp. 8-11, 2022. Crossref, https://doi.org/10.14445/23939117/IJMS-V9I2P102

Abstract:

This study aims to determine the predictive value of RDW in a patient with acute exacerbation of COPD and determine the other factor related to mortality during hospitalization. A prospective cohort study was conducted on 112 patients. They are selected from the Department of pulmonary disease, Tishreen University Hospital in Lattakia-Syria, between January 2020 and January 2021. Blood samples were taken, and a complete blood count CBC was performed to know the RDW value at admission. Results Of the 112 patients enrolled in the study,70(62.5%) had a high RDW value above (14.6%). A higher RDW value at admission was associated with a higher rate of mortality (P=0,0001), the need for NIMV(P= 0.02), the failure of NIMV(P=0.01), and a higher RDW value was associated with increased length of hospital stay(P= 0.04). The statistical variables were inserted into the logistic regression equation to identify the independent indicators for the warning of death within the hospital. We found that the high level of RDW is a prognostic biomarker of death in hospitals (OR=3.9, P=0,0001). In addition to that, the presence of heart failure in the medical history of the patients (OR=2.2, P=0.001), higher Pco2 value(OR=3.2, P=0.005), and PH< 7,30 (OR=2.7, P=0.001).

Keywords:

RDW, COPD, Acute Exacerbation, Prognosis.

References:

[1] Lozano R, Naghavi M, Foreman K, et al., Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study. 380 (2012) 2095-128.
[2] Bonaque JC, Pascual-Figal DA, Manzano-Fernandez S, et al., Red Blood Cell Distribution Width Adds Prognostic Value for Outpatients with Chronic Heart Failure, Rev ESP Cardiol (Engl Ed). 65(7) (2012) 606–612.
[3] Huang YL, Hu ZD, Liu SJ, et al., Prognostic Value of Red Blood Cell Distribution Width for Patients with Heart Failure: A Systematic Review and Meta-Analysis of Cohort Studies, PLOS ONE. 9(8) (2014) e104861.
[4] Akboga MK, Yayla C, Yilmaz S, et al., Increased Red Cell Distribution Width Predicts Occlusion of the Infarct-Related Artery in STEMI, Scand Cardiovasc J. 50(2) (2016) 114–118.
[5] Loprinzi PD, Comparative Evaluation of Red Blood Cell Distribution Width and High Sensitivity C-Reactive Protein in Predicting All-Cause Mortality and Coronary Heart Disease Mortality, Int J Cardiol. 223 (2016) 72–73.
[6] Wan H, Yang Y, Zhu J, et al., The Relationship Between Elevated Red Cell Distribution Width and Long-Term Outcomes Among Patients with Atrial Fibrillation, Clin Biochem. 48(12) (2015) 762–767.
[7] Lee KH, Park HW, Cho JG, et al., Red Cell Distribution Width as a Novel Predictor for Clinical Outcomes in Patients with Paroxysmal Atrial Fibrillation, Europace. 17(2) (2015) ii83–ii88.
[8] Lee JH, Chung HJ, Kim K, et al., Red Cell Distribution Width as a Prognostic Marker in Patients with Community-Acquired Pneumonia, Am J Emerg Med. 31(1) (2013) 72–79.
[9] Topaz G, Kitay-Cohen Y, Peled L, et al., The Association Between Red Cell Distribution Width and Poor Outcomes in Hospitalized Patients with Influenza, J Crit Care. 41 (2017) 166–169.
[10] Tertemiz KC, Ozgen Alpaydin A, et al., Could Red Cell Distribution Width Predict COPD Severity? Rev Port Pneumol. 22(4) (2016) 196– 201.
[11] Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red Blood Cell Distribution Width: A Simple Parameter with Multiple Clinical Applications, Crit Rev Clin Lab Sci. 52(2) (2015) 86-105. Doi: 10.3109/10408363.2014.992064.
[12] Patil SP, Krishnan JA, Lechtzin N, Diette GB, In-Hospital Mortality Following Acute Exacerbations of Chronic Obstructive Pulmonary Disease, Arch Intern Med. 163 (2003) 1180-6.
[13] Fruchter O, Yigla M, Predictors of Long-Term Survival in Elderly Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease, Respirology. 13 (2008) 851-5.
[14] Roche N, Zureik M, Soussan D, Neukirch F, Perrotin D, Predictors of Outcomes in COPD Exacerbation Cases Presenting to the Emergency Department, Eur Respir J. 32 (2008) 953-61.
[15] Gaude GS, Rajesh BP, Chaudhury A, Hattiholi J, Outcomes Associated with Chronic Obstructive Pulmonary Disorder Acute Exacerbations Requiring Hospitalization, Lung India. 32 (2015) 465- 72.
[16] Warwick R, Mediratta N, Shackcloth M, Shaw M, McShane J, Poullis M, Preoperative Red Cell Distribution Width in Patients Undergoing Pulmonary Resections for Non-Small-Cell Lung Cancer, European Journal of Cardiothoracic Surgery: Official Journal of the European Association for Cardiothoracic Surgery. 45 (2014) 108-13.
[17] Koma Y, Onishi A, Matsuoka H, et al., Increased Red Blood Cell Distribution Width Associates with Cancer Stage and Prognosis in Patients with Lung Cancer, Plos One. 8 (2013) e80240.
[18] Hampole CV, Mehrotra AK, Thenappan T, Gomberg-Maitland M, Shah SJ, The Usefulness of Red Cell Distribution Width as a Prognostic Marker in Pulmonary Hypertension, The American Journal of Cardiology. 104 (2009) 868-72.
[19] Abul Y, Ozsu S, Korkmaz A, Bulbul Y, Orem A, Ozlu T, Red Cell Distribution Width: A New Predictor for Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Embolism, Chronic Respiratory Disease. 11 (2014) 73-81.
[20] Zorlu A, Bektasoglu G, Guven FM, et al., Usefulness of Admission Red Cell Distribution Width as a Predictor of Early Mortality in Patients with Acute Pulmonary Embolism, The American Journal of Cardiology. 109 (2012) 128-34.
[21] Hong N, Oh J, Kang SM, et al., Red Blood Cell Distribution Width Predicts Early Mortality in Patients with Acute Dyspnea, Clinica Chimica Acta; International Journal of Clinical Chemistry. 413 (2012) 992-7.
[22] Braun E, Kheir J, Mashiach T, Naffaa M, Azzam ZS, Is Elevated Red Cell Distribution Width a Prognostic Predictor in Adult Patients with Community-Acquired Pneumonia? BMC Infectious Diseases. 14 (2014) 129.
[23] Seyhan EC, Ozgul MA, Tutar N, Omur I, Uysal A, Altin S, Red Blood Cell Distribution and Survival in Chronic Obstructive Pulmonary Disease Patients, Copd. 10 (2013) 416-24.
[24] M. R. Condon et al., Appearance of an Erythrocyte Population with Decreased Deformability and Hemoglobin Content Following Sepsis. 07103 (2021) 2177–2184.
[25] Y. Arbel et al., Red Blood Cell Distribution Width (RDW) and LongTerm Survival in Patients with ST Elevation Myocardial Infarction, Thromb. Res. 134(5) (2014) 976–979.
[26] V. Jeney, G. Balla, and J. Balla, Red Blood Cell, Hemoglobin and Heme in the Progression of Atherosclerosis, Front. Physiol. 5 (2014) 379.
[27] E. el din S. Ibrahim, S. A. McLellan, and T. S. Walsh, Red Blood Cell 2,3-Diphosphoglycerate Concentration and in Vivo P50 During Early Critical Illness*, Crit. Care Med. 33(10) (2005).
[28] S. C. Rogers, A. Said, D. Corcuera, D. Mclaughlin, P. Kell, and A. Doctor, Hypoxia Limits Antioxidant Capacity in Red Blood Cells by Altering Glycolytic Pathway Dominance. 3159–3170. Doi: 10.1096/fj.09-130666.
[29] A. S. Said, P. C. Spinella, and M. E. Hartman, Red Blood Cell Distribution Width: Biomarker for Red Cell Dysfunction and Critical Illness Outcome?. 18(2) (2018) 134–142. Doi: 10.1097/PCC.0000000000001017.Red.
[30] Song Yu YY-h, Wang C, Predictive Value of Red Cell Distribution Width on the Short-Term Prognosis of Chronic Obstructive Pulmonary Disease, Chinese J Pract Intern Med. 35(3) (2015) 239–241.
[31] Yang HJ, Liu X, Qu C, Shi SB, Liang JJ, Yang B, Usefulness of Red Blood Cell Distribution Width to Predict Heart Failure Hospitalization in Patients with Hypertrophic Cardiomyopathy, Int Heart J. 59(4) (2018) 779–785.
[32] Since I, Zorlu A, Yilmaz MB, et al., Relationship Between Red Cell Distribution Width and Right Ventricular Dysfunction in Patients with Chronic Obstructive Pulmonary Disease, Heart Lung. 41(3) (2012) 238–243.