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Eyiol A, Ertekin B. Association of red blood cell distribution width to albumin ratio with prognosis in stroke patients. Biomark Med 2024. [PMID: 38648096 DOI: 10.2217/bmm-2023-0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Aim: The authors investigated the association of red blood cell distribution width to albumin ratio (RAR) with prognosis and severity in acute ischemic stroke (AIS). Methods: One hundred twenty-seven patients with AIS were prospectively analyzed. The NIH Stroke Scale was used to determine stroke severity. RAR was compared between severe and nonsevere patients. Results: RAR was significantly higher in severe compared with nonsevere patients (p < 0.001). According to receiver operating characteristic analysis, RAR alone predicted mortality better than red blood cell distribution width and albumin (area under the curve: 0.933, 0.911, 0.870, respectively). Additionally, RAR was significantly correlated with NIH Stroke Scale score (p < 0.001). Conclusion: High RAR measured at presentation is a feasible index for prognosis and severity stratification in AIS.
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Affiliation(s)
- Azmi Eyiol
- Department of Cardiology, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
| | - Birsen Ertekin
- Department of Emergency, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
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Yu S, Xiong L, Wei D, Zhu H, Cai X, Shao L, Hong L, Zhan Y. Prediction of the left ventricular mass index in hypertensive patients using the product of red cell distribution width and mean corpuscular volume. Medicine (Baltimore) 2024; 103:e37685. [PMID: 38579056 PMCID: PMC10994413 DOI: 10.1097/md.0000000000037685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 04/07/2024] Open
Abstract
The product of red cell distribution width (RDW) and mean corpuscular volume (MCV) has been identified as an indicator of target organ damage in cases of hypertension. However, the role of the RDW-MCV product in assessing carotid alteration, renal damage, and left ventricular hypertrophy in patients with hypertension has not been elucidated. In this cross-sectional study, a total of 1115 participants with hypertension were included. The RDW and MCV at admission were measured using an automated hematology analyzer. Organ damage was determined by the left ventricular mass index (LVMI), carotid intima-media thickness, and estimated glomerular filtration rate. The prevalence rates of carotid alteration and left ventricular hypertrophy were 57.0% and 18.0%, respectively. A higher RDW-MCV product and RDW were observed in hypertensive patients who developed carotid alteration. After adjusting for potential confounding factors, the correlations of the RDW-MCV product (P = .285) and RDW (P = .346) with carotid alteration were not significant. Moreover, the analysis of variance showed no significant correlation between RDW and LVMI (P = .186). However, the RDW-MCV product was higher in individuals with a high LVMI compared to those with a normal LVMI. Multivariable linear regression analysis revealed that the RDW-MCV product was independently associated with the LVMI (β = 2.519, 95% CI: 0.921-4.116; P = .002), but not the estimated glomerular filtration rate (β = -0.260, 95% CI: -2.031-1.511; P = .773). An elevated RDW-MCV product may be a predictor for left ventricular hypertrophy in patients with hypertension.
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Affiliation(s)
- Songping Yu
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Lingbing Xiong
- The Second Department of Cardiology, The Third Hospital of Nanchang, Nanchang, Jiangxi, China
| | - Dan Wei
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Hongmin Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Xinyong Cai
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Liang Shao
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Lang Hong
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yuliang Zhan
- Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Wang J, He L, Jin Z, Lu G, Yu S, Hu L, Fang M, Jin X. Immune Dysfunction-Associated Elevated RDW, APACHE-II, and SOFA Scores Were a Possible Cause of 28-Day Mortality in Sepsis Patients. Infect Drug Resist 2024; 17:1199-1213. [PMID: 38560707 PMCID: PMC10981425 DOI: 10.2147/idr.s442169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To explore the early predictors and their predicting value of 28-day mortality in sepsis patients and to investigate the possible causes of death. Methods 127 sepsis patients were included, including 79 cases in the survival group and 48 cases in the death group. The results of all patients on admission were recorded. After screening the risk factors of 28-day mortality, the receiver operating characteristic curve (ROC) was used to determine their predictive value for the 28-day mortality rate on admission, and the Kaplan-Meier curve was drawn to compare the 28-day mortality rate between groups. Finally, patients with cytokine and lymphocyte subsets results were included for investigating the possible causes of death through correlation analysis. Results APACHE II (acute physiology and chronic health evaluation II), SOFA (Sequential Organ Failure Assessment) and red blood cell distribution width (RDW) were the risk factors for 28-day mortality in sepsis patients (OR: 1.130 vs.1.160 vs.1.530, P < 0.05). The area under the curve (AUC), sensitivity and specificity of APACHE II, SOFA and RDW in predicting the mortality rate at 28 days after admission in sepsis patients were 0.763 vs 0.806 vs 0.723, 79.2% vs 68.8% vs 75.0%, 65.8% vs 89.9% vs 68.4%. The combined predicted AUC was 0.873, the sensitivity was 89.6%, and the specificity was 82.3%. The Kaplan-Meier survival curve showed that the 28-day mortality rates of sepsis patients with APACHE II≥18.5, SOFA≥11.5 and RDW≥13.8 were 58.5%, 80.5% and 59.0%, respectively. In the death group, APACHE II was positively correlated with SOFA, IL-2, and IL-10, and RDW was positively correlated with PLT, TNF-α, CD3+ lymphocyte count, and CD8+ lymphocyte count. Conclusion Sepsis patients with high APACHE II, SOFA and RDW levels at admission have an increased 28-day mortality rate. The elevation of these indicators in dead patients are related to immune dysfunction.
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Affiliation(s)
- Jing Wang
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Lisha He
- Department of Ultrasound, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Zhiyan Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Guoguang Lu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Sufei Yu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Lingling Hu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Meidan Fang
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
| | - Xiaxia Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Taizhou, Zhejiang Province, People’s Republic of China
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Jian W, Shen X, Zheng Z, Wu Z, Shi Y, Liu J. Association Between Red Blood Cell Distribution Width and Coronary Calcification in Patients Referred for Invasive Coronary Angiography. Angiology 2024:33197241238509. [PMID: 38468156 DOI: 10.1177/00033197241238509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
This study aimed to determine whether red cell distribution width (RDW) is associated with coronary calcification. A total of 4796 patients who underwent coronary computed tomography angiography and subsequent invasive coronary angiography were consecutively enrolled. Coronary artery calcium score (CACS), demographic, clinical, and laboratory data were collected from electronic medical records. RDW were expressed in two forms, as a coefficient of variation (CV) or as a standard deviation (SD). Multivariable ordinal logistic regression was used to investigate the association of RDW with CACS grades (CACS 0-99, 100-399, 400-999, and >1000). A significant association was found between elevated RDW-SD and higher CACS grades after full adjustment (adjusted OR per 1-SD increase: 1.11, 95% CI: 1.05-1.18; P < .001), while no significant association was found between RDW-CV and CACS grades. When RDW-SD was analyzed as a categorical variable, it was primarily the 4th quartile of RDW-SD that was associated with elevated CACS grades compared with the 1st quartile (adjusted OR: 1.25, 95% CI: 1.07-1.46; P = .006), while the 2nd and 3rd quartiles showed no significantly higher risk. RDW-SD is a more robust biomarker for coronary calcification compared with RDW-CV.
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Affiliation(s)
- Wen Jian
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Xueqian Shen
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Ze Zheng
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Zheng Wu
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Yuchen Shi
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Jinghua Liu
- Center for Coronary Artery Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
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Kayacık Günday Ö, Yılmazer M. Combined delta neutrophil index and red blood cell distribution width as a new biomarker to predict endometriosis. J Turk Ger Gynecol Assoc 2024; 25:30-37. [PMID: 38058127 PMCID: PMC10921080 DOI: 10.4274/jtgga.galenos.2023.2022-11-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023] Open
Abstract
Objective The aim of this study was to evaluate the use of delta neutrophil index (DNI) in predicting endometriosis. Material and Methods A retrospective, case-control study was performed in a tertiary care center. DNI, red cell distribution width (RDW), and other blood parameters obtained from complete blood counts of 267 patients, consisting of 122 (45.7%) endometriosis patients with proven pathology reports of stages 3-4, and a control group of 145 women who underwent laparoscopy for simple ovarian cyst and/or diagnostic purposes and had normal histopathology, were compared. Receiver operating characteristic and logistic regression analyses were performed. Results DNI and RDW were significantly higher in endometriosis patients than in the control group (p=0.034 and p=0.003, respectively). Other parameters obtained from complete blood counts (leukocyte, neutrophil, lymphocyte, monocytes, and platelet counts and neutrophil-to-lymphocyte ratio), did not differ (p>0.05). For DNI, at a cut-off value of 0.025, area under the curve (AUC) was 0.572 and it was statistically significant [p=0.042; 95% confidence interval (CI): 0.503-0.642, sensitivity: 45.9%, specificity: 67.6%, Youden’s index: 0.135]. For RDW, AUC: 0.601 for cut-off value of 13.65 was statistically significant (p=0.004, 95% CI: 0.553-0.669, sensitivity: 50.8%, specificity: 67.6%, Youden’s index: 0.184). The logistic regression model established with the combined marker obtained by multiplying the DNI and RDW was statistically significant (p<0.001, Nagelkerke R2=0.72, 95% CI: 2.58-47.26, B: 2.40, negative predictive value: 78.6%, positive predictive value: 37.7%). Conclusion DNI, a new inflammatory marker, and RDW, known to be associated with inflammation, may be useful minimally invasive biomarkers of endometriosis.
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Affiliation(s)
- Özlem Kayacık Günday
- Department of Obstetrics and Gynecology, Afyonkarahisar University of Health Sciences Faculty of Medicine, Afyonkarahisar, Turkey
| | - Mehmet Yılmazer
- Department of Obstetrics and Gynecology, Afyonkarahisar University of Health Sciences Faculty of Medicine, Afyonkarahisar, Turkey
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Tan Y, Li Y, Huang X, Zhai Z, Wang Q, Guo Y, Li J, Lu W. The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study. J Inflamm Res 2024; 17:1227-1240. [PMID: 38410420 PMCID: PMC10896106 DOI: 10.2147/jir.s451769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/20/2024] [Indexed: 02/28/2024] Open
Abstract
Objective To explore the relationship between red blood cell distribution width to albumin (RDW/ALB) ratio (RAR) and the risk of rehospitalization and rehospitalization all-cause mortality in middle-aged and elderly survivors with sepsis based on an ambispective longitudinal cohort from the Intensive Care Unit (ICU). Methods Between 2017 and 2022, 455 adults who survived the first-episode severe sepsis without recurrence for at least 3 months were included in this study. All participants were followed up every 4 weeks for 12 months. According to the tertiles of RAR, participants were divided into three groups: low-level (≤0.36, n = 152), moderate-level (0.37-0.44, n = 152), and high-level (≥0.45, n = 151). The relationship between RAR and the risk of rehospitalization and rehospitalization all-cause mortality was evaluated. Results Out of 455 participants, 156 experienced rehospitalization (34.3%), of which 44 (28.2%) died. Receiver operating characteristic (ROC) analysis showed that the RAR cut-off values for rehospitalization and rehospitalization all-cause mortality were 0.4251 and 0.4743, respectively. Multivariate Cox regression analysis indicated that the RAR was positively associated with rehospitalization (P = 0.011) and all-cause mortality (P = 0.006). Compared with the low-level, the high-level RAR presented a higher dose-dependent rehospitalization risk (P = 0.02) and rehospitalization all-cause mortality (P = 0.044). The stratified analysis displayed that compared to the low-level, with the RAR increasing by 1.0, the risk for rehospitalization increased 3.602-fold in aged <65 patients (P = 0.002) and 1.721-fold in female patients (P = 0.014). Kaplan-Meier survival analysis implied a significant positive association between the RAR and the cumulative incidence of rehospitalization and rehospitalization all-cause mortality (log-rank, all P < 0.001). Conclusion RAR has a reliable predictive value for the risk of rehospitalization and rehospitalization all-cause mortality in patients with sepsis. Consequently, monitoring RAR for at least 1 year after surviving sepsis in female patients aged <65 in clinical practice is critical.
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Affiliation(s)
- Yanni Tan
- Department of Endocrinology and Respiratory of the Third People’s Hospital of Nanning, Nanning, Guangxi, 530003, People’s Republic of China
| | - Yameng Li
- Medical Department of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Xiuxian Huang
- Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Zhenwei Zhai
- Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Qiu Wang
- Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Yanli Guo
- Yuncheng Vocational and Technical University, Yuncheng, Shanxi, 044000, People’s Republic of China
| | - Junjun Li
- Hospital Dean’s Office of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Wensheng Lu
- Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
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Vasilatis DM, Ghosh PM. Clinicopathologic Characterization of Prostatic Cancer in Dogs. Animals (Basel) 2024; 14:588. [PMID: 38396556 PMCID: PMC10886256 DOI: 10.3390/ani14040588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Clinicopathologic data in dogs with prostate cancer (PCa) may aid in the differentiation between tumor types and subsequent treatment decisions; however, these data are often unreported. Demographic, clinicopathologic, cytologic, histologic and survival data from dogs with primary prostatic adenocarcinoma (PRAD) (n = 56) and primary prostatic transitional cell carcinoma (P-TCC) (n = 74) were acquired from a tertiary veterinary teaching hospital from 1992 to 2022. Red blood cell distribution width (RDW) to albumin ratio (RAR) was evaluated for diagnostic utility in differentiating between PRAD and P-TCC. Sections from PRAD tumors (n = 50) were stained for androgen receptor (AR) expression, and laboratory data were compared between AR positive (AR+) and AR negative (AR-) groups. RDW was increased in PRAD, while albumin was decreased (p < 0.05). P-TCC was associated with Melamed-Wolinska bodies (MWB) and necrosis on cytology (p < 0.05). RAR had acceptable diagnostic utility in the differentiation of PCa tumors (AUC = 0.7; p < 0.05). Survival rates and metastases were equivocal. AR+ and AR- PRAD tumors did not differ in clinicopathologic data or survival (p > 0.05). In conclusion, hypoalbuminemia was significantly associated with PRAD and decreased survival, while MWB and necrosis were significantly associated with P-TCC on cytology. These clinicopathologic data may help clinicians differentiate between these tumors ante mortem to guide appropriate treatment and intervention.
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Affiliation(s)
- Demitria M. Vasilatis
- Department of Urologic Surgery, School of Medicine, University of California Davis, Sacramento, CA 95718, USA;
- Veterans Affairs (VA)—Northern California Healthcare System, Mather, CA 95655, USA
| | - Paramita M. Ghosh
- Department of Urologic Surgery, School of Medicine, University of California Davis, Sacramento, CA 95718, USA;
- Veterans Affairs (VA)—Northern California Healthcare System, Mather, CA 95655, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA 95718, USA
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Wang H, Xie D, Wang S, Wu L, Chu Y, Yang P, He W, Wang J. The value of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red blood cell distribution width in predicting positive surgical margin after laparoscopic radical prostatectomy. Cancer Rep (Hoboken) 2024; 7:e1977. [PMID: 38258491 PMCID: PMC10849998 DOI: 10.1002/cnr2.1977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/07/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Prostate cancer (PCa) is one of the most common malignant tumors in men, and laparoscopic radical prostatectomy (LRP) is commonly used to treat localized and advanced PCa. Positive surgical margin (PSM) is one of the most frequent problems faced by surgeons. AIMS This study aimed to explore the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in predicting PSM after LRP. METHODS AND RESULTS Three hundred and twenty patients with PCa were admitted and underwent LRP in Beijing Chaoyang Hospital from January 2017 to June 2023. Patients were randomly divided into a training set (225 cases) and a validation set (95 cases) in a 7:3 ratio. NLR, PLR, and RDW were significantly higher in the PSM group than in the negative surgical margins (NSM) group. In addition, the NLR, PLR, and RDW values correlated with clinical T stage, Gleason score, and seminal vesicle invasion in the PSM group. In training set, ROC curve analysis revealed that the optimal cutoff values of NLR, PLR, and RDW for predicting postoperative PSM in PCa were 2.31, 115.40, and 12.85%, respectively. Multivariate Logistic regression analysis showed NLR and RDW were the clinical independent predictors. The area under the curve (AUC, 0.770, 95% CI 0.709-0.831) for postoperative PSM was the highest when a combination of the three parameters was used, with sensitivity and specificity of 62.5% and 85.2%, respectively. In validation set, the AUC values for NLR, PLR, RDW and the three markers combined were 0.708, 0.675, 0.723, and 0.780, respectively. Correlation analysis showed that in the PSM group, NLR was positively correlated with PLR and RDW, and PLR was positively correlated with RDW. By contrast, in the NSM group, a positive association was only found between NLR and PLR. CONCLUSIONS Higher preoperative NLR, PLR, and RDW values were associated with postoperative PSM. Additionally, the three markers combined may be useful to predict PSM.
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Affiliation(s)
- Hao Wang
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Dawei Xie
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Siqi Wang
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Liyang Wu
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Yifan Chu
- Department of UrologyCapital Medical University Daxing Teaching HospitalBeijingChina
| | - Pushen Yang
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Weifeng He
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
| | - Jianwen Wang
- Department of UrologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
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Li D, Yang A, Xia M, Ma K, Zhang J, Guo Y, Zang W. Association between red blood cell distribution width-to-albumin ratio and the prognosis in patients with autoimmune encephalitis: a retrospective cohort study. Front Neurol 2024; 14:1276026. [PMID: 38274889 PMCID: PMC10808499 DOI: 10.3389/fneur.2023.1276026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Aim Red blood cell distribution width-to-albumin ratio (RAR) is a combined new indicator reflecting immunology and has been reported to predict the prognosis of inflammation-related diseases and brain diseases. However, the association and predictive value of RAR in the prognosis of patients with autoimmune encephalitis (AE) has not been reported. Methods This was a retrospective cohort study, and data were collected from the Henan Provincial People's Hospital. RAR was categorized according to quartile. The prognosis was assessed using the modified Rankin Scale (mRS), and an mRS score of ≥3 was defined as a poor prognosis. The logistical regression model was used to explore the association between RAR and the prognosis, with results reported as odds ratio (OR) and 95% confidence interval (CI). The predictive value of RAR was evaluated by calculating the area under the receiving operating curve (AUC), sensitivity, specificity, and accuracy. Results A total of 175 eligible patients were included for analysis, and 51 patients were identified as having poor prognosis. After adjusting age, cancer, other diseases, histological subtype, antiepileptic therapy, anti-tumor treatment, ICU treatment, and length of stay, RAR in the highest quartile (Q4) was found to be significantly associated with the high odds of poor prognosis (OR = 5.63, 95%CI: 1.98-16.02) compared to RAR in the lowest quartile (Q1). In addition, RAR was identified as a predictor for the prognosis of AE patients (AUC = 0.660, 95%CI: 0.574-0.746). Conclusion This study found the close association and predictive value of RAR for the prognosis of AE patients, indicating that RAR might help clinicians identify high-risk populations.
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Affiliation(s)
- Dan Li
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Ali Yang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Mingrong Xia
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Kai Ma
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Jiewen Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Yang Guo
- Department of Neurosurgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Weizhou Zang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
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Zhu L, Chen Z, Jiang H, Wang P, Hu T, Gao M, Hu X, Lin M, Liu X, Zhang W. Association of red blood cell distribution width and hemoglobin-to-RDW ratio with contrast-associated acute kidney injury in patients undergoing coronary angiography: A retrospective study. Clin Cardiol 2024; 47:e24163. [PMID: 37794705 PMCID: PMC10768739 DOI: 10.1002/clc.24163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Inflammation contributes to poor prognosis in cardiovascular diseases. A novel biomarker for systemic inflammation that has garnered attention is the red blood cell distribution width (RDW). This study is designed to explore potential associations between RDW and hemoglobin-to-RDW ratio (HRR) with contrast-associated acute kidney injury (CA-AKI). METHODS This study retrospectively analyzed 4054 patients undergoing coronary angiography (CAG). Linear regression models were employed to assess the relationships between RDW or HRR and the elevation of serum creatinine (Scr). The associations between RDW or HRR and CA-AKI were explored using restricted cubic spline and log-binomial regression analyses taking into account specific cutoff values and quintiles. Exploratory analyses were also conducted to further investigate these associations. RESULTS Among enrolled patients, the average age was 66.9 years and 34.3% were female. Notably, patients who developed CA-AKI tended to have higher RDW and lower HRR. Multivariable linear regression models demonstrated that RDW exhibited a positive association with Scr elevation (β = 2.496, 95% confidence interval [CI] = 1.784-3.208), while HRR displayed a negative association (β = -3.559, 95% CI = -4.243 to -2.875). Multivariable log-binomial regression models confirmed that both high RDW (RDW ≥ 13.8%) and low HRR (HRR < 8.9) were significantly associated with a higher risk of CA-AKI (RDW [≥13.8% vs. <13.8%]: relative risk [RR] = 1.540, 95% CI = 1.345-1.762; HRR [<8.9 vs. ≥8.9]: RR = 1.822, 95% CI = 1.584-2.096). Exploratory analysis determined that such associations still existed regardless of age, gender, estimated glomerular filtration rate, or anemia. CONCLUSIONS Elevated preoperative RDW and decreased HRR were significantly associated with CA-AKI in patients undergoing CAG.
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Affiliation(s)
- Lijie Zhu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
| | - Zhezhe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
| | - Hangpan Jiang
- Department of Cardiology, The Fourth Affiliated Hospital, College of MedicineZhejiang UniversityYiwuZhejiangChina
| | - Peng Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
| | - Tianli Hu
- Department of Cardiology, The Fourth Affiliated Hospital, College of MedicineZhejiang UniversityYiwuZhejiangChina
| | - Menghan Gao
- Department of Cardiology, College of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Xiaolong Hu
- Department of Cardiology, College of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Maoning Lin
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
| | - Xianglan Liu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
| | - Wenbin Zhang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of MedicineZhejiang UniversityHangzhouZhejiangChina
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang ProvinceHangzhouZhejiangChina
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Caimi G, Carlisi M, Presti RL. Red Blood Cell Distribution Width, Erythrocyte Indices, and Elongation Index at Baseline in a Group of Trained Subjects. J Clin Med 2023; 13:151. [PMID: 38202157 PMCID: PMC10780127 DOI: 10.3390/jcm13010151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Regular exercise elicits adaptive changes in several organs and physiological processes, including erythrocyte properties. METHODS In a group of 79 subjects (62 men and 17 women; mean age 31.37 ± 10.19 years) who trained several times a week as they practiced amateur sports, we evaluated the elongation index, markers of erythrocyte deformability, red blood cell distribution width (RDW), indicators of erythrocyte anisocytosis, hematocrit, hemoglobin, and the main erythrocyte indices (MCV, MCH, MCHC) in basal conditions. RESULTS In comparison with a group of healthy, but not training, volunteers, the values of the elongation index, and not the RDW, are increased, and this datum is accompanied by an increase in MCV and MCHC, likely related to an increased presence of circulating young erythrocytes in training subjects. We also divided the same group according to the median of the VO2max, observing that the subgroup above the median shows both an increase in the elongation index values and a decrease in MCH and MCHC. CONCLUSIONS In trained subjects, there is no correlation between the values of the elongation index and the RDW, while the interrelations among the elongation index, RDW, and main erythrocyte indices appear to be of particular interest and of a certain complexity.
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Affiliation(s)
- Gregorio Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy;
| | - Melania Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy;
| | - Rosalia Lo Presti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90127 Palermo, Italy;
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Zhang Y, Lv Z, Peng P, Zhao T. Association between red blood cell distribution width and psoriasis among the US adults. Front Med (Lausanne) 2023; 10:1290514. [PMID: 38179271 PMCID: PMC10764517 DOI: 10.3389/fmed.2023.1290514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction The association between red blood cell distribution width (RDW) and psoriasis among the US adults is still unknown. We aimed to assess whether RDW is associated with psoriasis in the US adults. Method We conducted a cross-sectional study consisting of 14,089 participants from National Health and Nutrition Examination Survey (NHANES) 2009-2014. Psoriasis status were assessed by self-reported questionnaire. We evaluated the association between RDW and risk of psoriasis using multivariate regression models. Subgroup and interaction analysis were performed. Results The higher RDW level was associated with an increased risk of psoriasis (OR = 1.10 [95% CI, 1.01, 1.19]; p = 0.025) after adjusting for confounders in female. However, there is no significant association between RDW and risk of psoriasis among male (OR = 0.99 [95% CI, 0.87, 1.15]; p = 0.992). Subgroup and interaction analysis found that the strongest positive association mainly exists in female participants with BMD greater than 29.9 kg/m2 (OR = 1.20 [95% CI, 1.09, 1.32], Pint = 0.004). Discussion In conclusion, we found that increased RDW levels were associated with an increased risk of psoriasis in females, which could provide clinicians with auxiliary data for the early diagnosis of psoriasis.
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Affiliation(s)
- Yunqi Zhang
- Department of Pharmacy, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Zheng Lv
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Peng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tie Zhao
- Department of Pharmacy, Guangzhou Institute of Dermatology, Guangzhou, China
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Wang J, Zhao J, Lin Q, Xu X, Jiang K, Li Y. ΔRDW Could Predict Major Adverse Cardiovascular Events in Patients with Heart Failure with Reduced Ejection Fraction After Sacubitril/Valsartan Treatment. Int J Gen Med 2023; 16:5989-6003. [PMID: 38144439 PMCID: PMC10748743 DOI: 10.2147/ijgm.s444585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/09/2023] [Indexed: 12/26/2023] Open
Abstract
Objective This study aimed to evaluate the association between red blood cell distribution width (RDW) changes and major adverse cardiovascular event (MACE) occurrences during sacubitril/valsartan treatment in patients with heart failure with reduced ejection fraction (HFrEF). Methods This study retrospectively analyzed the medical records of patients with HFrEF hospitalized from April 2018 to February 2021. The patients were divided into two groups according to the inclusion of sacubitril/valsartan in the personal drug treatment regimen, the traditional and the sacubitril/valsartan group. RDW values before and after sacubitril/valsartan treatment were recorded respectively as RDW1 and RDW2. ΔRDW was defined as the difference between RDW2 and RDW1. The patients in the sacubitril/valsartan group were divided into two subgroups according to ΔRDW >0 or ≤0. MACEs, such as readmission for HF, acute myocardial infarction, ischemic stroke, and malignant arrhythmia and death, were recorded during the 1-year follow-up period in each group. Results MACE development was lower in patients treated with sacubitril/valsartan than those treated with conventional therapy (log-rank, P<0.001). The incidence of cardiac events during the follow-up period was greater in the group with ΔRDW >0 than in the group with ΔRDW ≤0 (Breslow, P<0.001). Increased RDW was associated with a higher likelihood of developing MACE than decreased RDW (odds ratio [OR] =2.055, 95% confidence interval [CI]:1.301-3.246), and the risk of developing MACE increased by 22.1% for each unit increase in RDW (OR=1.221, 95% CI:1.074-1.389). Conclusion Sacubitril/valsartan treatment is effective in reducing the risk of MACEs in HFrEF. Additionally, RDW changes are predictors of MACEs after sacubitril/valsartan treatment.
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Affiliation(s)
- Jingsheng Wang
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
| | - Jian Zhao
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
| | - Quanqiang Lin
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
| | - Xiuxiu Xu
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
| | - Ke Jiang
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
| | - Yuanmin Li
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People’s Republic of China
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Zhang X, Zhang Y, Liu F, Zhu J, Liang X, Shi X, Han L, Xu K, Cheng H. Red blood cell distribution width as a prognostic factor in patients with aplastic anemia treated with cyclosporin A plus androgen or cyclosporine A alone: a retrospective study. Hematology 2023; 28:2240665. [PMID: 37594305 DOI: 10.1080/16078454.2023.2240665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To explore the prognostic value of red blood cell distribution width (RDW) in newly diagnosed aplastic anemia (AA) patients treated with cyclosporine A (CsA) plus androgen or CsA alone. METHODS We retrospectively analyzed the clinical outcome of 220 patients with AA. According to the baseline level of RDW before treatment, the patients were divided into the high-RDW group (RDW ≥ 15%) and the normal-RDW group (RDW < 15%). RESULTS The median RDW of non-severe AA (NSAA) and severe AA (SAA) patients was 15.65% and 15.35%, respectively; this were significantly higher than that of very severe AA (VSAA) patients (13.35%). With median follow-up being 46 months, AA patients in the high-RDW group showed better 5-year OS and PFS than the normal-RDW group (93%: 75.3%; 74.3%: 61%). There was a higher ORR in the high-RDW group than the normal-RDW group (68.7%: 52.3%). The ORR of NSAA patients in the high-RDW group was better than that in the normal RDW group (75.8%: 60%). The 5-year OS of SAA/VSAA patients in the high-RDW group was significantly higher than the normal-RDW group (81.8%: 50.8%). CONCLUSION This is the first documentation on the prognostic value of RDW in AA patients receiving CsA treatment with long-term follow-up, which had shown that high RDW at diagnosis was a better prognostic factor.
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Affiliation(s)
- Xiaotian Zhang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Yanan Zhang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Fengan Liu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Zhu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xiuli Liang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xuedong Shi
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Li Han
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Kailin Xu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
- Institute of Hematology, Xuzhou Medical University, Jiangsu, China
- Key Laboratory of Bone Marrow Stem Cell, Xuzhou, People's Republic of China
| | - Hai Cheng
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
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Tang X, Qiu L, Wang F, Liu S, Lü X, Chen X. Diagnostic value of procalcitonin and red blood cell distribution width at admission on the prognosis of patients with severe burns: A retrospective analysis. Int Wound J 2023; 20:3708-3716. [PMID: 37381890 PMCID: PMC10588303 DOI: 10.1111/iwj.14263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/20/2023] [Indexed: 06/30/2023] Open
Abstract
The plasma procalcitonin (PCT) concentration and red blood cell distribution (RDW) value after severe burns can be used as prognostic indicators, but at present, it is difficult to give consideration to sensitivity and specificity in diagnosing the prognosis of severe burns with a single indicator. This study analysed the diagnostic value of plasma PCT concentration and RDW value at admission on the prognosis of severe burn patients to improve its sensitivity and specificity. A total of 205 patients with severe burns who were treated in the First Affiliated Hospital of Anhui Medical University from November 2017 to November 2022 were retrospectively analysed. The optimal cut-off values of plasma PCT concentration and RDW were analysed and counted through the subject curve (ROC curve). According to the cut-off value, patients were divided into high PCT group and low PCT group, high RDW group and low RDW group. The independent risk factors of severe burns were analysed by single-factor and multiple-factor COX regression. Kaplan-Meier survival was used to analyse the mortality of high PCT group and low PCT group, high RDW group and low RDW group. The area under the curve of plasma PCT concentration and RDW value at admission was 0.761 (95% CI, 0.662-0.860, P < .001), 0.687 (95% CI, 0.554-0.820, P = .003) respectively, and the optimal cut-off values of serum PCT concentration and RDW were 2.775 ng/mL and 14.55% respectively. Cox regression analysis found that age, TBSA, and RDW were independent risk factors for mortality within 90 days after severe burns. Kaplan-Meier survival analysis showed that there was a significant difference in the 90-day mortality rate of severe burns between the PCT ≥ 2.775 ng/mL group and the PCT < 2.775 ng/mL group (log-rank: 24.162; P < .001), with the mortality rate of 36.84% versus 5.49%, respectively. The 90-day mortality rate of severe burns was significantly different between the RDW ≥ 14.55% group and the RDW < 14.55% group (log-rank: 14.404; P < .001), with the mortality rate of 44% versus 12.2% respectively. The plasma PCT concentration and RDW value at admission are both of diagnostic value for the 90-day mortality of severe burns, but the plasma PCT concentration has higher sensitivity and the RDW value has higher specificity. Age, TBSA, and RDW were independent risk factors for severe burns, and then plasma PCT concentration was not independent risk factors.
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Affiliation(s)
- Xu‐Dong Tang
- Department of BurnsThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Le Qiu
- Department of BurnsThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Fei Wang
- Department of BurnsThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Sheng Liu
- Department of BurnsThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Xiong‐Wen Lü
- School of PharmacyAnhui Medical UniversityHefeiAnhui ProvinceChina
- Institute for Liver Disease of Anhui Medical UniversityAnhui Medical UniversityHefeiAnhui ProvinceChina
| | - Xu‐Lin Chen
- Department of BurnsThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
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Mu Y, Wang H, Tian M, Hu Y, Feng Y, Lu R, He Q, Jiang S, Huang J, Duan S, Mu D. Cross-sectional association between red blood cell distribution width and regional cerebral tissue oxygen saturation in preterm infants in the first 14 days after birth. Front Pediatr 2023; 11:1238762. [PMID: 38027304 PMCID: PMC10644271 DOI: 10.3389/fped.2023.1238762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Hypoxia can threaten the metabolic functions of different systems in immature neonates, particularly the central nervous system. The red blood cell distribution width (RDW) has recently been reported as a prognostic factor in neurologic diseases. Herein, we examined the correlation between RDW and regional cerebral tissue oxygen saturation (rcSO2). Methods This cross-sectional study included 110 preterm infants born at a gestational age (GA) of <32 weeks, or with a birth weight (BW) of <1,500 g at our institution between January and June 2,022. The rcSO2 was monitored using near-infrared spectroscopy, and RDW was extracted from the complete blood count during the first 14 days after birth. RDW and rcSO2 measurements were analyzed using a cross-sectional research method. Results We divided the study population into two groups, with a mean rcSO2 value over the first 14 days. Fifty-three preterm had rcSO2 ≥ 55% and 57% < 55%. The 14-days-mean in the study population showing an association of lower rcSO2 values with higher RDW values. Significantly higher RDW values were observed in the low rcSO2 group compared with those in the high rcSO2 group. Threshold effect analysis showed that rcSO2 decreased with RDW values ≥18% (β, -0.03; 95% CI, -0.04 and -0.02; p ≥ 0.0001). After adjusting for potential confounders, an RDW of ≥18% was determined as the predictive cutoff value for preterm infants with low rcSO2 (Model I: OR, 3.31; 95% CI, 1.36-8.06; p = 0.009; and Model II: OR, 3.31; 95% CI, 1.28-8.53; p = 0.013). Conclusions An RDW of ≥18% in the first 14 days is associated with rcSO2 of <55% in preterm infants.
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Affiliation(s)
- Yuju Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Hua Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Mengting Tian
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yong Hu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yi Feng
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Ruifeng Lu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Qi He
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Shouliang Jiang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Jinglan Huang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Surong Duan
- Department of Clinical Medicine, BinZhou Medical College, Yantai, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Disease ofWomen and Children, Ministry of Education, Sichuan University, Chengdu, China
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Yang K, Sun B, Zhang S, Pan Y, Fang J. RDW-SD is Superior to RDW-CV in Reflecting Liver Fibrosis Stage in Patients with Chronic Hepatitis B. Infect Drug Resist 2023; 16:6881-6891. [PMID: 37920477 PMCID: PMC10619233 DOI: 10.2147/idr.s427047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Purpose The clinical significance of the red blood cell distribution width (RDW)-coefficient of variation (RDW-CV) has been recognized in numerous diseases, but few studies have investigated the usefulness of RDW-standard deviation (RDW-SD). This study aimed to compare the utility of RDW-SD and RDW-CV in evaluating liver fibrosis stage in patients with chronic hepatitis B (CHB). Patients and Methods In this retrospective study, we enrolled 720 treatment-naïve CHB patients and 578 healthy controls, and evaluated their clinical parameters. In CHB patients, the associations between RDW-CV and liver fibrosis stage were analyzed as compared to RDW-SD using one-way analysis of variance (ANOVA), Spearman's rank correlation, student's t-test, binary logistic regression, and receiver operating characteristic (ROC) curve. Results RDW-SD, rather than RDW-CV was significantly elevated in CHB patients compared with healthy controls. Correlation analysis showed a stronger association between RDW-SD and liver fibrosis stage than RDW-CV in CHB patients. RDW-CV and RDW-SD are both independent predictors of significant fibrosis. For the diagnosis of significant fibrosis, the area under the receiver operating characteristic curve (AUC) for RDW-CV was 0.599, while for RDW-SD, it was 0.706. RDW-to-platelet ratio (RPR), a novel index for liver fibrosis calculated as RDW-CV/platelet, exhibited an AUC of 0.730. This AUC increased to 0.752 when RDW-CV in the RPR formula was replaced with RDW-SD. Additionally, subgroup analyses based on age, gender, and HBeAg status showed that the AUC for RDW-SD in diagnosing significant fibrosis was significantly greater than that for RDW-CV, with statistically significant differences. Conclusion RDW-SD showed superiority in reflecting liver fibrosis stage and diagnosing liver significant fibrosis than RDW-CV in treatment-naïve CHB patients.
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Affiliation(s)
- Kai Yang
- Department of Medical Technology, Anhui Medical College, Hefei, Anhui, 230601, People’s Republic of China
| | - Beibei Sun
- Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of China
| | - Shicheng Zhang
- School of Public Health and Health Management, Anhui Medical College, Hefei, Anhui, 230601, People’s Republic of China
| | - Ying Pan
- Department of Medical Technology, Anhui Medical College, Hefei, Anhui, 230601, People’s Republic of China
| | - Jun Fang
- Faculty of Pharmaceutical Science, Sojo University, Kumamoto, 860-0082, Japan
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Wen ZL, Zhou X, Peng D. Red blood cell distribution width has a prognostic value for gastric cancer patients after gastrectomy: A pooling-up analysis. Medicine (Baltimore) 2023; 102:e35554. [PMID: 37832121 PMCID: PMC10578666 DOI: 10.1097/md.0000000000035554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Our study aims to investigate whether preoperative red blood cell distribution width (RDW) has a prognostic value for patients after gastric cancer (GC) surgery. We searched articles in 3 databases including PubMed, Embase, and the Cochrane Library on May 16th, 2022. The prognostic indicators included overall survival (OS) and disease-free survival (DFS). RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom) and Stata V16.0 were used for statistical analysis. The Risk Of Bias In Non-randomized Studies-of Interventions tool was used to assess risk of bias of the included studies. Ten articles involving 2740 patients were included. RDW was a prognostic factor for OS (hazard ratio = 1.81, 95% confidence interval [CI] = 1.38-2.37, P < .01) and DFS (hazard ratio = 1.99, I2 = 26%, 95% CI = 1.53-2.58, P < .01) for GC patients. Meanwhile, there were some differences between the high RDW group and the low RDW group. We found more patients older than 60 years old (OR = 2.58, 95% CI = 1.08-6.13, P = .03), larger tumor diameter (OR = 1.95, 95% CI = 1.33-2.85, P < .01) and later T stage (OR = 1.91, 95% CI = 1.07-3.42, P = .03) in the high RDW group than the low RDW group. No statistic difference was found in gender, N stage, tumor node metastasis stage, vascular invasion, differentiation, and adjuvant therapy between the 2 groups (P > .05). RDW was an independent prognostic factor for both OS and DFS of GC patients. High RDW level were strongly associated with poor survival.
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Affiliation(s)
- Ze-Lin Wen
- Department of Gastrointestinal Surgery, Yongchuan Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiong Zhou
- Department of Gastrointestinal Surgery, Yongchuan Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Hong WS, Rudas A, Bell EJ, Chiang JN. Association of red blood cell distribution width with hospital admission and in-hospital mortality across all-cause adult emergency department visits. JAMIA Open 2023; 6:ooad053. [PMID: 37501917 PMCID: PMC10368803 DOI: 10.1093/jamiaopen/ooad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
Objectives To test the association between the initial red blood cell distribution width (RDW) value in the emergency department (ED) and hospital admission and, among those admitted, in-hospital mortality. Materials and Methods We perform a retrospective analysis of 210 930 adult ED visits with complete blood count results from March 2013 to February 2022. Primary outcomes were hospital admission and in-hospital mortality. Variables for each visit included demographics, comorbidities, vital signs, basic metabolic panel, complete blood count, and final diagnosis. The association of each outcome with the initial RDW value was calculated across 3 age groups (<45, 45-65, and >65) as well as across 374 diagnosis categories. Logistic regression (LR) and XGBoost models using all variables excluding final diagnoses were built to test whether RDW was a highly weighted and informative predictor for each outcome. Finally, simplified models using only age, sex, and vital signs were built to test whether RDW had additive predictive value. Results Compared to that of discharged visits (mean [SD]: 13.8 [2.03]), RDW was significantly elevated in visits that resulted in admission (15.1 [2.72]) and, among admissions, those resulting in intensive care unit stay (15.3 [2.88]) and/or death (16.8 [3.25]). This relationship held across age groups as well as across various diagnosis categories. An RDW >16 achieved 90% specificity for hospital admission, while an RDW >18.5 achieved 90% specificity for in-hospital mortality. LR achieved a test area under the curve (AUC) of 0.77 (95% confidence interval [CI] 0.77-0.78) for hospital admission and 0.85 (95% CI 0.81-0.88) for in-hospital mortality, while XGBoost achieved a test AUC of 0.90 (95% CI 0.89-0.90) for hospital admission and 0.96 (95% CI 0.94-0.97) for in-hospital mortality. RDW had high scaled weights and information gain for both outcomes and had additive value in simplified models predicting hospital admission. Discussion Elevated RDW, previously associated with mortality in myocardial infarction, pulmonary embolism, heart failure, sepsis, and COVID-19, is associated with hospital admission and in-hospital mortality across all-cause adult ED visits. Used alone, elevated RDW may be a specific, but not sensitive, test for both outcomes, with multivariate LR and XGBoost models showing significantly improved test characteristics. Conclusions RDW, a component of the complete blood count panel routinely ordered as the initial workup for the undifferentiated patient, may be a generalizable biomarker for acuity in the ED.
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Affiliation(s)
- Woo Suk Hong
- Department of Emergency Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Akos Rudas
- Department of Computational Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Elijah J Bell
- Department of Emergency Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Jeffrey N Chiang
- Corresponding Author: Jeffrey N. Chiang, PhD, Department of Computational Medicine, University of California Los Angeles David Geffen School of Medicine, 621 Charles E Young Dr S, Room 5217 Life Sciences Bldg., Los Angeles, CA 90095, USA;
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Alghamdi M. Red Blood Cell Distribution Width: A Potential Inexpensive Marker for Disease Activity in Patients with Rheumatic Diseases; Scoping Review. Open Access Rheumatol 2023; 15:173-180. [PMID: 37719317 PMCID: PMC10505028 DOI: 10.2147/oarrr.s424168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
Background Rheumatic diseases encompass a diverse group of autoimmune disorders that affect the joints and connective tissues. The red blood cell distribution width (RDW) has been widely investigated as an inflammatory marker. This scoping review aimed to explore the potential utility of RDW as an inexpensive marker for disease activity in patients with rheumatic diseases. By summarizing the available evidence, we aimed to determine whether RDW can serve as a reliable and accessible indicator of disease activity in these patients. Methods A comprehensive search was systematically performed across electronic databases, encompassing PubMed, Embase, and Web of Science. Studies have explored the relationship between RDW and disease activity in rheumatic diseases. Data extraction focused on the study characteristics, methodologies, and findings related to RDW as a disease activity marker. Results After removing duplicates, the initial search yielded 25 relevant studies. These studies encompassed a variety of rheumatic diseases, with rheumatoid arthritis being the most frequently studied condition. The association between RDW and disease activity was assessed by using various disease activity indices and clinical parameters. While some studies have reported a significant correlation between elevated RDW and disease activity, others have yielded inconclusive results. Conclusion From this review, we concluded that RDW is an inexpensive potential marker for the evaluation of disease activity in rheumatic diseases. RDW is promising as an inexpensive and readily available marker; however, its clinical utility in assessing disease activity in rheumatic conditions warrants more rigorous investigation through well-designed prospective studies.
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Affiliation(s)
- Mushabab Alghamdi
- Department of Internal Medicine, College of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia
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21
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Sun K, Zhang J, Chen Y, Hu Y, He Y, Chen Z, Wu X, Mao Y, Wu J, Sheng L. A dynamic nomogram integrated with blood inflammation markers for predicting overall survival in patients with upper tract urothelial carcinoma. Transl Androl Urol 2023; 12:1259-1272. [PMID: 37680231 PMCID: PMC10481205 DOI: 10.21037/tau-23-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/19/2023] [Indexed: 09/09/2023] Open
Abstract
Background Upper tract urothelial carcinoma (UTUC) is a relatively rare disease with a poor prognosis. A growing body of evidence demonstrates that inflammation and the inflammatory microenvironment play a crucial role in tumorigenesis and tumor progression. Our aim was to evaluate the prognostic value of blood inflammation markers and develop a prediction model that incorporates inflammation markers in order to predict overall survival (OS) of UTUC. Methods We included 304 localized UTUC patients from two medical institutions who had undergone radical nephroureterectomy (RNU) (167 in the training cohort, 137 in the validation cohort). Univariate and multivariate Cox regression analyses were performed to screen the prognostic factors, and a nomogram and a web-based calculator were generated based on these predictors. The Harrell's concordance index (C-index), the area under the receiver operating characteristic (ROC) curve, the calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. Results Independent predictors incorporated in the nomogram were pathological stage, surgical margin, albumin-to-globulin ratio (AGR), and hemoglobin-to-red cell distribution width ratio (HRR). The c-index value was 0.726 in the training cohort and 0.761 in the validation cohort. The area under the ROC of the nomogram at 1-, 3- and 5-year in the training and validation sets were 0.765, 0.755, 0.763, and 0.791, 0.833, 0.802, respectively. Both the internal and external validation calibration plots showed a subtle distinction between the predicted and the actual probabilities. And it appears to provide incremental benefits for clinical decision-making in comparison to the American Joint Committee of Cancer (AJCC) staging system. Conclusions In patients with UTUC after RNU, lower preoperative AGR and HRR were independent predictors of inferior survival. In addition, we created a novel blood inflammation marker-based dynamic nomogram that may be useful for surgeons or oncologists in risk stratification and patient selection for more intensive therapy and closer follow-up.
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Affiliation(s)
- Kening Sun
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jinxiong Zhang
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yiling Chen
- Department of Urology, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yun Hu
- Department of Urology, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yijun He
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Zhihao Chen
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Xin Wu
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yongxin Mao
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jianhong Wu
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Lu Sheng
- Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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22
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Frater JL. Comment on: Hematological parameters and early-onset coronary artery disease: a retrospective case-control study based on 3366 participants. Ther Adv Chronic Dis 2023; 14:20406223231185248. [PMID: 37529506 PMCID: PMC10388617 DOI: 10.1177/20406223231185248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
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23
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Xuan C, Wang H. Author response to comment on: Hematological parameters and early-onset coronary artery disease: a retrospective case-control study based on 3366 participants. Ther Adv Chronic Dis 2023; 14:20406223231185250. [PMID: 37529505 PMCID: PMC10388614 DOI: 10.1177/20406223231185250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Affiliation(s)
| | - Huan Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
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Cai S, Li Y, Sun B, Wang K, Wan Z, Yang D, Tian X, Wu L, Zhu R. Red blood cell distribution width combined with age as a predictor of acute ischemic stroke in stable COPD patients. Front Neurol 2023; 14:1165181. [PMID: 37342782 PMCID: PMC10277555 DOI: 10.3389/fneur.2023.1165181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Aim This retrospective study aimed to investigate the independent clinical variables associated with the onset of acute cerebral ischemic stroke (AIS) in patients with stable chronic obstructive pulmonary disease (COPD). Method A total of 244 patients with COPD who had not experienced a relapse within 6 months were included in this retrospective study. Of these, 94 patients hospitalized with AIS were enrolled in the study group, and the remaining 150 were enrolled in the control group. Clinical data and laboratory parameters were collected for both groups within 24 h after hospitalization, and the data of the two groups were statistically analyzed. Results The levels of age, white blood cell (WBC), neutrophil (NEUT), glucose (GLU), prothrombin time (PT), albumin (ALB), and red blood cell distribution width (RDW) were different in the two groups (P < 0.01). Logistic regression analysis showed that age, WBC, RDW, PT, and GLU were independent risk factors for the occurrence of AIS in patients with stable COPD. Age and RDW were selected as new predictors, and the receiver operating characteristic curves (ROC) were plotted accordingly. The areas under the ROC curves of age, RDW, and age + RDW were 0.7122, 0.7184, and 0.7852, respectively. The sensitivity was 60.5, 59.6, and 70.2%, and the specificity was 72.4, 86.0, and 60.0%, respectively. Conclusion The combination of RDW and age in patients with stable COPD might be a potential predictor for the onset of AIS.
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Affiliation(s)
- Shikun Cai
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Yao Li
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Bo Sun
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Kai Wang
- Department of Rheumatology and Immunology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Zongren Wan
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Dan Yang
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Xiangyang Tian
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Liao Wu
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Rong Zhu
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
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25
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Di Lorenzo B, Pau MC, Zinellu E, Mangoni AA, Paliogiannis P, Pirina P, Fois AG, Carru C, Zinellu A. Association between Red Blood Cell Distribution Width and Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12093302. [PMID: 37176740 PMCID: PMC10179738 DOI: 10.3390/jcm12093302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047).
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Affiliation(s)
- Biagio Di Lorenzo
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Maria Carmina Pau
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Elisabetta Zinellu
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedfor Park, SA 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia
| | | | - Pietro Pirina
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Alessandro G Fois
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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Shen Z, Huang Y, Zhou Y, Jia J, Zhang X, Shen T, Li S, Wang S, Song Y, Cheng J. Association between red blood cell distribution width and ischemic stroke recurrence in patients with acute ischemic stroke: a 10-years retrospective cohort analysis. Aging (Albany NY) 2023; 15:3052-3063. [PMID: 37053005 DOI: 10.18632/aging.204657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023]
Abstract
Numerous studies have reported that a higher red blood cell distribution width (RDW) level was associated with adverse outcomes in patients with the first stroke. However, no studies have examined the association between RDW and recurrent ischemic stroke. We performed a population-based cohort data analysis from 2007 to 2017. Baseline RDW was measured in 6402 first ischemic stroke participants, who were followed for about five years on average. During 62 months of median follow-up, 205 participants (3.20%) reported a recurrence (self-reported). RDW showed a nonlinear relationship with the risk of ischemic stroke recurrence. When RDW was assessed as quartiles (quartile 1, RDW<12.4; quartile 2, 12.4 to 12.8; quartile 3,12.8 to 13.3, quartile4, RDW>13.3), compared with the reference group (quartile 1), the hazard ratios (HRs) of ischemic stroke recurrence were 1.372 (95% confidence interval [CI]=0.671-2.805, P=0.386) in quartile 2, 1.835 (95% CI=1.222-2.755, P=0.003) in quartile 3, and 1.732 (95% CI=1.114-2.561, P<0.001) in quartile 4. The trend test was significant (P<0.001). When quartiles 3 and 4 were combined, the adjusted HR of ischemic stroke recurrence was 1.439 (95% CI=1.330-1.556, P<0.001) compared with the combined quartiles 1 and 2 subgroups. This study demonstrated that elevated RDW levels were positively associated with an increased risk of recurrent ischemic stroke. RDW can provide a new perspective for initial risk assessment and identify high-risk patients early. Further research is required to confirm our results.
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Affiliation(s)
- Zhan Shen
- Department of Geratology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Ying Huang
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of General Medicine, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Ying Zhou
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of General Medicine, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jingying Jia
- Department of Central Laboratory, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Xian Zhang
- Department of Geratology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Tingting Shen
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of General Medicine, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Shengjie Li
- Shanghai Internet Hospital Engineering Technology Research Center, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Siyang Wang
- Department of Geratology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yunxiao Song
- Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jie Cheng
- Department of Geratology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Neurology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Urinary Surgery, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, People’s Republic of China
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Jin F, Chang X, Wang X, Xiong H, Wang L, Zhang B, Wang P, Zhao L. Relationship between red blood cell-related indices and coronary artery calcification. Postgrad Med J 2023; 99:4-10. [PMID: 36947423 DOI: 10.1093/postmj/qgac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 09/18/2022] [Accepted: 09/25/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Red blood cell (RBC) indices such as RBC count and RBC distribution width (RDW) are associated with heart failure and coronary artery disease, but the relationship between RBC indices and coronary artery calcification (CAC) is unclear. This study aimed to investigate RBC indices' correlation with, and predictive value for, the presence and severity of CAC. METHODS In this study, 1257 hospitalized patients who received a coronary computed tomography angiography examination were finally selected. Patients were classified into a control group (without CAC, n = 655) and a calcification group (with CAC, n = 602) according to their CAC score. The calcification group was further divided into a low calcification group, medium calcification group, and high calcification group. RESULTS In the calcification group, the RBC count was lower, and the RDW-standard deviation (SD) and RDW-coefficient of variation (CV) were higher, than those in the control group (P < .05). In the high calcification group, the RBC count was significantly lower, and the RDW-SD and RDW-CV were significantly higher, than those in the low calcification group (P < .05). Multivariate logistic regression analysis showed that RBC count, RDW-SD, and RDW-CV were independent predictors of CAC presence. Furthermore, multivariate logistic regression analysis also showed that RBC count and RDW-SD were independent predictors of severe CAC. CONCLUSIONS RBC indices were significantly associated with the presence and severity of CAC, indicating that these RBC indices have the potential to be predictors of CAC.
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Affiliation(s)
- Fulu Jin
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiansong Chang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiaozhong Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Hui Xiong
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Li Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Bo Zhang
- Radiology Department, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004 China
| | - Peiyu Wang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Liangping Zhao
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
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Roumeliotis S, Neofytou IE, Maassen C, Lux P, Kantartzi K, Papachristou E, Schurgers LJ, Liakopoulos V. Association of Red Blood Cell Distribution Width and Neutrophil-to-Lymphocyte Ratio with Calcification and Cardiovascular Markers in Chronic Kidney Disease. Metabolites 2023; 13:metabo13020303. [PMID: 36837922 PMCID: PMC9966770 DOI: 10.3390/metabo13020303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
We aimed to investigate the association between Red Blood Cell Distribution Width (RDW) and Neutrophil-to-Lymphocyte Ratio (NLR), simple, rapidly assessed markers from the complete blood count with vascular calcification (VC)/stiffness and cardiovascular disease (CVD) in chronic kidney disease (CKD). Dephosphorylated, uncarboxylated matrix Gla-protein (dp-ucMGP), and central/peripheral hemodynamics' parameters were measured in 158 CKD patients, including Hemodialysis and Peritoneal Dialysis. Spearman's rho analysis showed that RDW correlated with C-reactive protein (CRP) (r = 0.29, p < 0.001), dp-ucMGP (r = 0.43, p = < 0.0001), central diastolic blood pressure (DBP) (r = -0.19, p = 0.02), and albuminuria (r = -0.17, p = 0.03). NLR correlated with the duration of CVD (r = 0.32, p < 0.001), CRP (r = 0.27, p = 0.01), dp-ucMGP (r = 0.43, p < 0.0001), central DBP (r = -0.32, p < 0.0001) and eGFR (r = -0.25, p = 0.04). In multiple regression models, circulating dp-ucMGP was an independent predictor of RDW (β = 0.001, p = 0.001) and NLR (β = 0.002, p = 0.002). In CKD patients, RDW and NLR are associated with traditional and novel markers of VC and CVD.
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Affiliation(s)
- Stefanos Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- Correspondence: ; Tel./Fax: +30-2310994694
| | - Ioannis E. Neofytou
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Cecile Maassen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Petra Lux
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Konstantia Kantartzi
- Department of Nephrology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Evangelos Papachristou
- Department of Nephrology and Renal Transplantation, Patras University Hospital, 26504 Patras, Greece
| | - Leon J. Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Zhang B, Xu Y, Huang X, Sun T, Ma M, Chen Z, Zhou Y. Red Blood Cell Distribution Width: A Risk Factor for Prognosis in Patients with Ischemic Cardiomyopathy after Percutaneous Coronary Intervention. J Clin Med 2023; 12. [PMID: 36836116 DOI: 10.3390/jcm12041584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND It has been demonstrated in previous studies that red blood cell distribution width (RDW) is correlated with the severity and prognosis of cardiovascular disease. The target of our study was to assess the relationship between RDW and the prognosis of ischemic cardiomyopathy (ICM) patients undergoing percutaneous coronary intervention (PCI). METHODS The study retrospectively enrolled 1986 ICM patients undergoing PCI. The patients were divided into three groups by RDW tertiles. The primary endpoint was major adverse cardiovascular events (MACE) and the secondary endpoints were each of the components of MACE (all-cause mortality, nonfatal myocardial infarction (MI) and any revascularization). Kaplan-Meier survival analyses were conducted to show the association between RDW and the incidence of adverse outcomes. The independent effect of RDW on adverse outcomes was determined by multivariate Cox proportional hazard regression analysis. In addition, the nonlinear relationship between RDW values and MACE was explored using restricted cubic spline (RCS) analysis. The relationship between RDW and MACE in different subgroups was determined using subgroup analysis. RESULTS As RDW tertiles increased, the incidences of MACE (Tertile 3 vs. Tertile 1: 42.6 vs. 23.7, p < 0.001), all-cause death (Tertile 3 vs. Tertile 1: 19.3 vs. 11.4, p < 0.001) and any revascularization (Tertile 3 vs. Tertile 1: 20.1 vs. 14.1, p < 0.001) increased significantly. The K-M curves showed that higher RDW tertiles were related to increased incidences of MACE (log-rank, p < 0.001), all-cause death (log-rank, p < 0.001) and any revascularization (log-rank, p < 0.001). After adjusting for confounding variables, RDW was proved to be independently associated with increased risks of MACE (Tertile 3 vs. Tertile 1: HR, 95% CI: 1.75, 1.43-2.15; p for trend < 0.001), all-cause mortality (Tertile 3 vs. Tertile 1: HR, 95% CI: 1.58, 1.17-2.13; p for trend < 0.001) and any revascularization (Tertile 3 vs. Tertile 1: HR, 95% CI: 2.10, 1.54-2.88; p for trend < 0.001). In addition, the RCS analysis suggested nonlinear association between RDW values and MACE. The subgroup analysis revealed that elderly patients or patients with angiotensin receptor blockers (ARBs) had a higher risk of MACE with higher RDW. Patients with hypercholesterolemia or without anemia also had a higher risk of MACE. CONCLUSIONS RDW was significantly related to the increased risk of MACE among ICM patients undergoing PCI.
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Liu C, Zhang K, Zhang T, Sha X, Xu Y, Gu J, Tian Y, Liu Y, Cao J, Mi W, Li H. Higher Preoperative Red Blood Cell Distribution Width Increases the Risk of Myocardial Injury After Noncardiac Surgery in Advanced-Age Patients: A Retrospective Cohort Study. Clin Interv Aging 2023; 18:169-179. [PMID: 36818546 PMCID: PMC9930678 DOI: 10.2147/cia.s392778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/19/2023] [Indexed: 02/12/2023] Open
Abstract
Background Myocardial injury after noncardiac surgery (MINS) has been associated with worse outcomes. The aim of our study was to investigate the relationship between higher red blood cell distribution width (RDW) and postoperative 30-day MINS among advanced-age patients. Methods This was a retrospective observational study including advanced-age patients (≥65 years old) who underwent noncardiac surgery between January 2017 and August 2019 at the First Medical Center of the Chinese People's Liberation Army General Hospital. Patients were divided into two groups according to the cutoff value identified the lowest risk using Restricted Cubic Splines (RCS) model. The primary outcome was the incidence of MINS within 30 days after surgery. The relationship between RDW and MINS was investigated by univariable and multi-variable logistic regression analysis. Propensity score (PS) analysis, including propensity score matching (PSM) and inverse probability treatment weighting (IPTW), as well as subgroup analysis were also conducted to identify the effect of RDW. Results The result of the RCS analysis showed that the risk of MINS in advanced-age patients increases when the baseline RDW is >12.8%. In the univariate analysis, baseline RDW >12.8% was a risk factor for postoperative MINS [odds ratio (OR)=2.11; 95% confidence interval (CI): 1.83-2.44; p<0.001]. After adjustment for all possible components, there was also a high risk of MINS for patients with elevated RDW [Adjusted OR (aOR)=1.43; 95% CI: 1.27-1.61; p<0.001). The relationship remained after PS analysis (aOR=1.24; 95% CI: 1.04-1.47; p=0.016 in PSM; aOR=1.23; 95% CI: 1.05-1.44; p=0.012 in IPTW, respectively). Significant differences between two groups were established in the incidence rate of postoperative cardiac complications and mortality. Conclusion Elevated preoperative RDW is significantly associated with an increased risk of MINS within postoperative 30 days.
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Affiliation(s)
- Chang Liu
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Kai Zhang
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Ting Zhang
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China
| | - Xiaoling Sha
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China
| | - Yuhai Xu
- Anesthesiology Department, Air Force Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Juanjuan Gu
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China
| | - Ye Tian
- Anesthesiology Department, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Yanhong Liu
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Jiangbei Cao
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Weidong Mi
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China,Correspondence: Weidong Mi; Hao Li, Medical School of Chinese PLA, Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, 28th Fuxing Road, Haidian District, Beijing, 100853, People’s Republic of China, Email ;
| | - Hao Li
- Department of Anesthesiology, The First Medical Center, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, People’s Republic of China,Medical School of Chinese PLA General Hospital, Beijing, People’s Republic of China
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Tian Q, Mitchell BA, Moaddel R, Zoccali C, Bandinelli S, Ferrucci L. Metabolomic markers mediate erythrocyte anisocytosis in older adults: Results from three independent aging cohorts. J Intern Med 2023; 293:589-599. [PMID: 36739565 DOI: 10.1111/joim.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Anisocytosis reflects unequal-sized red blood cells and is quantified using red blood cell distribution width (RDW). RDW increases with age and has been consistently associated with adverse health outcomes, such as cardiovascular disease and mortality. Why RDW increases with age is not understood. We aimed to identify plasma metabolomic markers mediating anisocytosis with aging. METHODS We performed mediation analyses of plasma metabolomics on the association between age and RDW using resampling techniques after covariate adjustment. We analyzed data from adults aged 70 or older from the main discovery cohort of the Baltimore Longitudinal Study of Aging (BLSA, n = 477, 46% women) and validation cohorts of the Health, Aging and Body Composition Study (Health ABC, n = 620, 52% women) and Invecchiare in Chianti, Aging in the Chianti Area (InCHIANTI) study (n = 735, 57% women). Plasma metabolomics was assayed using the Biocrates MxP Quant 500 kit in BLSA and Health ABC and liquid chromatography with tandem mass spectrometry in InCHIANTI. RESULTS In all three cohorts, symmetric dimethylarginine (SDMA) significantly mediated the association between age and RDW. Asymmetric dimethylarginine (ADMA) and 1-methylhistidine were also significant mediators in the discovery cohort and one validation cohort. In the discovery cohort, we also found choline, homoarginine, and several long-chain triglycerides significantly mediated the association between age and RDW. CONCLUSIONS AND RELEVANCE This metabolomics study of three independent aging cohorts identified a specific set of metabolites mediating anisocytosis with aging. Whether SDMA, ADMA, and 1-methylhistidine are released by the damaged erythrocytes with high RDW or they affect the physiology of erythrocytes causing high RDW should be further investigated.
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Affiliation(s)
- Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Brendan A Mitchell
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Ruin Moaddel
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
| | - Carmine Zoccali
- Institute of Biology and Molecular Genetics (BIOGEM), Ariano Irpino, Italy.,Associazione Ipertensione Nefrologia e Trapianto Renale (IPNET), Reggio Calabria, Italy
| | | | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
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Zhao Q, Mei J, Zhang X, Dong X, Zhang Y, Fan X. Determining Holistic Factors Related to Depressive Symptoms in Patients With Heart Failure. Clin Nurs Res 2023; 32:359-365. [PMID: 36068938 DOI: 10.1177/10547738221121437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Identifying modifiable factors associated with depressive symptoms is important to develop corresponding strategies. This study aimed to determine the holistic factors related to depressive symptoms in heart failure (HF) patients. It was a secondary analysis of a cross-sectional study. We recruited 329 hospitalized HF patients from two hospitals in China. It is found that HF patients had a relatively high proportion (28.27%) of depressive symptoms. Red blood cell distribution width (RDW) (β = .222, p = .011) and physical symptoms (β = .151, p < .001) were positively associated with depressive symptoms, whereas resilience (β = -.241, p < .01) and family functioning (β = -.288, p = .001) were negatively associated with depressive symptoms. Thus, early screening and management of depressive symptoms are warranted. RDW may serve as a marker for screening depressive symptoms. Moreover, interventions focused on relieving physical symptoms and enhancing resilience and family functioning may reduce depressive symptoms.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | | | - Xiuting Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaoyu Dong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Sun Y, Ren J, Li L, Wang C, Yao H. RDW as A Predictor for No-Reflow Phenomenon in DM Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. J Clin Med 2023; 12. [PMID: 36769459 DOI: 10.3390/jcm12030807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND No-reflow phenomenon (NRP) in ST-segment elevation myocardial infarction (STEMI) patients is not infrequent. The predictive value of red blood-cell distribution width (RDW) on NRP has not been explored. METHODS STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Plasma samples were obtained at admission. Participants were divided into two groups according to RDW. Logistic regression and receiver operating characteristic (ROC) curve were performed to evaluate the relationship between RDW and NRP. Subgroup analysis was made between the diabetes mellitus (DM) group and the No-DM group. RESULTS The high RDW group had a higher NRP compared to the low group. In multivariate logistic regression analysis, DM (adjusted odds ratio [AOR]:1.847; 95% confidence interval [CI]: 1.209-2.822; p = 0.005) and hemoglobin (AOR: 0.986; 95% CI: 0.973-0.999; p < 0.05), other than RDW, were independent predictors of NRP. RDW (AOR: 2.679; 95% CI: 1.542-4.655; p < 0.001) was an independent predictor of NRP in the DM group, but not in the No-DM group. In the DM group, area under the ROC curve value for RDW predicting NRP was 0.707 (77.3% sensitivity, 56.3% specificity (p < 0.001)). CONCLUSIONS RDW is a predictor of NRP in DM patients with STEMI, which provides further assistance in clinicians' decision making.
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Chen C, Zhong S, Wu Z, Tang H, Wang Z, Jiang D. Investigation of the relationship between red blood cell distribution width and mortality in patients with hemophagocytic lymphohistiocytosis: a retrospective study. SAO PAULO MED J 2023; 141:e2022190. [PMID: 36629554 PMCID: PMC10065090 DOI: 10.1590/1516-3180.2022.0190.r1.17102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/17/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is related to sepsis-related mortality. Hemophagocytic lymphohistiocytosis (HLH) is a syndrome caused by severe infection, tumors, or autoimmunity without a specific diagnosis. OBJECTIVE To explore the correlation between RDW and mortality in patients with HLH. DESIGN AND SETTING A retrospective study conducted in a hospital in China. METHODS A total of 101 inpatients with HLH from January 1, 2017 to December 31, 2021 were divided into non-survivor (n = 52) and survivor (n = 49) groups. A non-parametric test was used to analyze demographic, clinical, and laboratory data between groups. Independent variables with P < 0.05 were analyzed using binary logistic regression to screen out mortality-related variables. Selected variables were subjected to multivariate logistic regression analysis, and those with strong correlations were screened. Receiver operating characteristic (ROC) curves of strongly correlated variables and area under curve (AUC) values were obtained. RESULTS The APACHE II score, RDW, and platelet (PLT) and fibrinogen (FIB) levels (P < 0.05) different significantly. RDW, PLT, FIB were correlated with mortality. The AUC values of RDW, PLT, and FIB were 0.857, 0.797, and 0.726, respectively. RDW was associated with mortality in patients with HLH (P < 0.01, cut-off value: 16.9). The sensitivity and specificity of predicting mortality were 97.96% and 96.1%, respectively. CONCLUSION Logistic regression analysis showed a correlation between RDW and patients' mortality. Therefore, RDW can be used to predict mortality in patients with HLH.
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Affiliation(s)
- Chunyan Chen
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Shili Zhong
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Zhengbin Wu
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Hao Tang
- MD, PhD. Assistant Professor, Department of Intensive Care Unit,
Daping Hospital, Army Medical University, Chongqing, China
| | - Zhen Wang
- MD, PhD. Assistant Professor, Department of Intensive Care Unit,
Daping Hospital, Army Medical University, Chongqing, China
| | - Dongpo Jiang
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
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Ji X, Ke W. Red blood cell distribution width and all-cause mortality in congestive heart failure patients: a retrospective cohort study based on the Mimic-III database. Front Cardiovasc Med 2023; 10:1126718. [PMID: 37206106 PMCID: PMC10189655 DOI: 10.3389/fcvm.2023.1126718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Background The red blood cell distribution width (RDW) is a metric that measures the variation in the size of red blood cells and is presented as the red blood cell volume coefficient of variation. Increased RDW levels are closely linked to an elevated risk of death from congestive heart failure (CHF) and might be a new risk marker for cardiovascular disease. This research sought to evaluate the possible link between RDW levels and all-cause mortality in CHF patients after controlling for other covariates. Methods The publicly accessible Mimic-III database served as the source of data for our research. We employed ICU admission scoring systems to gather information on each patient's demographical data, laboratory test results, comorbid conditions, vital signs, and scores. Among CHF patients, the link between baseline RDW levels and short-, medium-, and long-term all-cause mortality was evaluated by Cox proportional hazard analysis, smooth curve fitting, and Kaplan-Meier survival curves. Results In total, 4,955 participants were selected for the study with an average age of 72.3 ± 13.5 years (old) and with males accounting for 53.1%. The findings recorded from the fully adjusted Cox proportional hazard model showed that higher RDW was associated with a greater risk of 30-day, 90-day, 365-day, and 4-year all-cause death; the HRs and 95% confidence intervals were 1.11 (1.05, 1.16), 1.09 (1.04, 1.13), 1.10 (1.06, 1.14), and 1.10 (1.06, 1.13), respectively. The results were stable and reliable using subgroup analysis. Smooth curve fitting and the K-M survival curve method further validated our results. Conclusion The RDW levels had a u-shaped connection with 30-day mortality. The RDW level was linked to an elevated risk of short-, medium-, and long-term all-cause death among CHF patients.
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Affiliation(s)
- Xuan Ji
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Weiqi Ke
- Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Correspondence: Weiqi Ke
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Wang Y, Zhu Y, Wang X, Zhong C, Qin Y, Sun Y, Cao Y, Zhang X, Chen D. Combined Role of Inflammatory Biomarkers and Red Blood Cell Distribution Width in Predicting In-hospital Outcomes of Acute Ischemic Stroke Patients Undergoing Thrombolysis. Curr Neurovasc Res 2023; 20:207-217. [PMID: 37282646 DOI: 10.2174/1567202620666230606120439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/16/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND To investigate the combined effect of red blood cell distribution width (RDW) and inflammatory biomarkers on in-hospital outcomes of acute ischemic stroke(AIS) patients with thrombolysis. METHODS 417 AIS patients with thrombolysis were included. The participants were divided into four groups according to the cut-off of white blood cell (WBC) or C reactive protein (CRP) and RDW: LWLR, LWHR, HWLR, and HWHR; or LCLR, LCHR, HCLR, and HCHR (L-low, Hhigh, W-WBC, C-CRP, R-RDW). Logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of in-hospital pneumonia and functional outcome across the four subgroups. RESULTS Patients with higher RDW and inflammatory biomarkers levels have the highest risk of in-hospital outcomes. Compared with patients in the LWLR group, the ORs (95% CIs) of those in the HWHR group were 12.16 (4.21-35.14) and 9.31 (3.19-27.17) for in-hospital pneumonia and functional outcome. The ORs (95% CIs) of those in the HCHR group were 6.93 (2.70-17.78) and 3.38 (1.10-10.39) for in-hospital pneumonia and functional outcome, compared with patients in the LCLR group. Simultaneously adding RDW and WBC or CRP to the basic model with established risk factors significantly improved risk discrimination and reclassification for pneumonia and functional outcome (all p <0.05). CONCLUSIONS Combined RDW and inflammatory biomarkers within 4.5 hours had a better predictive power for in-hospital outcomes of AIS patients with thrombolysis.
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Affiliation(s)
- Yi Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yafang Zhu
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaohong Wang
- Department of Outpatient, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yan Qin
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongrong Sun
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongjun Cao
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xia Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Dongqin Chen
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
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Sun X, Liu Y, Liu Y, Wang H, Liu B, Shi L. Association between red blood cell distribution width and left ventricular hypertrophy in pediatric essential hypertension. Front Pediatr 2023; 11:1088535. [PMID: 36816384 PMCID: PMC9932496 DOI: 10.3389/fped.2023.1088535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
AIM Left ventricular hypertrophy (LVH) is one of the most common types of target organ damage in hypertension. The red blood cell distribution width (RDW) is closely related to many cardiovascular diseases, including hypertension. The aim of this study was to analyze the relationship between the RDW level and LVH in pediatric essential hypertension. MATERIALS AND METHODS A total of 429 untreated children and adolescents with essential hypertension were recruited and divided into an LVH group (n = 114) and non-LVH group (n = 315) according to left ventricular mass index (LVMI) and relative wall thickness (RWT) by color Doppler ultrasound. Spearman correlation analysis was used to determine the relationship between RDW and LVMI, RWT. The effect of RDW on LVH was determined using a multivariate logistic regression analysis. To assess the predictive value of RDW on LVH, the receiver operating characteristic (ROC) curve was used. RESULTS The level of RDW in children with hypertension in the LVH group was significantly higher than that in the non-LVH group (13.0 [12.0, 13.0] vs. 12.4 [12.0, 13.0] %, P = 0.001). The incidence of low and high quantiles of LVH was 21.0% and 32.0%, respectively. Spearman correlation analysis showed that RDW was positively correlated with C-reactive protein (CRP), LVMI, RWT, and red blood cell (RBC) count (P all < 0.05), and negatively correlated with hemoglobin (HGB) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) (P all < 0.05). After adjusting for various confounding factors, a multivariate logistic regression model revealed that RDW was an independent risk factor for LVH (OR = 1.946, 95% CI: 1.324-2.861, P = 0.001). The area under the ROC curve of RDW predicting centripetal hypertrophy was 0.700 (95% CI: 0.541-0.859, P < 0.05) in pediatric essential hypertension. CONCLUSIONS Increased RDW levels are an independent risk factor for LVH in pediatric essential hypertension, and RDW may be a predictor of LVH in untreated pediatric essential hypertension.
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Affiliation(s)
- Xiaodong Sun
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yang Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yanyan Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Hui Wang
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Bo Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
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Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red Cell Distribution Width/Albumin Ratio: A Predictor of In-Hospital All-Cause Mortality in Patients with Acute Myocardial Infarction in the ICU. Int J Gen Med 2023; 16:745-756. [PMID: 36872940 PMCID: PMC9983434 DOI: 10.2147/ijgm.s393393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
Purpose Red cell distribution width (RDW) and albumin level are linked to adverse outcomes in patients with acute myocardial infarction (AMI). Nonetheless, it remains unknown whether the RDW/albumin ratio (RAR) is associated with the short-term prognosis of AMI. Using a large cohort, we aimed to explore the association between RAR and in-hospital all-cause mortality in intensive care unit (ICU) patients with AMI. Patients and Methods The patients' data analyzed in this retrospective cohort investigation were obtained from the eICU Collaborative Research Data Resource. RAR was calculated based on the serum albumin level and RDW. The primary outcome was in-hospital all-cause mortality. Receiver operating characteristic curve, multiple logistic regression model, and Kaplan-Meier survival analysis were performed to explore the prognostic value of RAR. Results We enrolled 2594 patients in this study. After correcting for confounding factors, the RAR was an independent predictor for in-hospital mortality in our model (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.12, 1.43). A similar relationship was observed with mechanical ventilation use. RAR showed a better predictive value with an area under the curve (AUC) of 0.738 (cutoff, 4.776) for in-hospital all-cause mortality compared to RDW or albumin alone. Kaplan-Meier estimator curve analyses for RAR demonstrated that the group with RAR ≥4.776%/g/dL had poorer survival than the group with RAR <4.776%/g/dL (p< 0.0001). The subgroup analysis revealed no significant interaction between RAR and in-hospital all-cause mortality in all strata. Conclusion RAR was an independent risk factor for in-hospital all-cause mortality in ICU patients with AMI. Higher RAR values corresponded to higher mortality rates. RAR is a more accurate predictor of in-hospital all-cause mortality in patients with AMI in the ICU than albumin or RDW. Thus, RAR may be a potential biomarker of AMI.
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Affiliation(s)
- Linhao Jian
- Department of the First Clinical College, Jinan University, Guangzhou, 510632, People's Republic of China.,Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Zhixiang Zhang
- Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Quan Zhou
- Department of Science and Education, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Xiangjie Duan
- Department of Infectious Diseases, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Liangqing Ge
- Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
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Caimi G, Lo Presti R, Corrado E, Montana M, Carlisi M. Red Cell Distribution Width and Elongation Index in a Cohort of Patients With Juvenile Acute Myocardial Infarction. Clin Appl Thromb Hemost 2023; 29:10760296231186148. [PMID: 37403324 DOI: 10.1177/10760296231186148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
In a cohort of patients with juvenile myocardial infarction, we considered the red cell distribution width (RDW), hematocrit, hemoglobin, and elongation index values at the initial phase and at 3 and 12 months from the acute event. In the initial phase, only the elongation index values turn out reduced if compared with those of the control group, and that only turn out to discriminate the infarcted ST-segment elevation myocardial infarction (STEMI) from non-STEMI. Dividing the patients according to the traditional risk factors and the extent of coronary heart disease, there are no significant variations in the analyzed parameters. No major changes are observed after 12 months from the acute event. Both to 3 and to 12 months from the infarct episode, the negative statistical correlation between RDW and the value of elongation index remains. These data make us reflect on the role of the degree of anisocytosis of red blood cell expressed by the RDW on the determinism of erythrocyte deformability, which plays its role in the microcirculation district and that is essential in the transfer of tissue oxygen.
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Affiliation(s)
- Gregorio Caimi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Rosalia Lo Presti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Egle Corrado
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Maria Montana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Melania Carlisi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Yin JM, Zhu KP, Guo ZW, Yi W, He Y, Du GC. Is red cell distribution width a prognostic factor in patients with breast cancer? A meta-analysis. Front Surg 2023; 10:1000522. [PMID: 37035565 PMCID: PMC10079877 DOI: 10.3389/fsurg.2023.1000522] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 02/14/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose The current study aimed to investigate whether red blood cell distribution width (RDW) can predict the prognosis of patients with breast cancer (BC). Methods We searched four databases, including PubMed, Embase, Cochrane Library databases, and CNKI, from inception to Jun 13, 2022. The primary outcome was overall survival (OS), and the secondary outcome was disease-free survival (DFS). A subgroup analysis was conducted based on different treatments. This meta-analysis was performed with RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom). Results A total of seven studies including 4,884 BC patients were identified. The high RDW group had a larger tumor size (OR = 2.12, 95% CI = 1.67 to 2.68, P < 0.01), higher proportions of advanced stage tumors (OR = 1.77, 95% CI = 1.38 to 2.27, P < 0.01), more lymph node metastases (OR = 2.00, 95% CI = 1.58 to 2.51, P < 0.01) and lower HER-2 expression (OR = 0.76, 95% CI = 0.61 to 0.95, P = 0.02). For prognosis, after pooling all the data, we found that the high RDW group was associated with worse OS (HR = 2.12, 95% CI = 1.47 to 3.08, P < 0.01) and DFS (HR = 1.77, 95% CI = 1.32 to 2.37, P < 0.01). The subgroup analysis found that RDW had prognostic significance but only for surgery-only patients (HR = 2.41, 95% CI = 1.67 to 3.49, P < 0.01). Conclusion High RDW was associated with worse OS and DFS. Therefore, RDW was a simple predictive factor for the prognosis of BC patients.
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Muacevic A, Adler JR, Almarshad K, BinSheeha T, Alghamdi D, Kabbani MS. Red Blood Cell Distribution Width as a Predictive Biomarker for Postoperative Infections in Children Who Underwent Cardiac Surgery: A Single-Center Retrospective Study. Cureus 2023; 15:e34051. [PMID: 36824560 PMCID: PMC9942246 DOI: 10.7759/cureus.34051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 01/23/2023] Open
Abstract
Background It has been investigated that red blood cell distribution width (RDW) is associated with the clinical outcomes of patients following surgeries and is used as a prognostic biomarker for postsurgical complications. In this study, we aimed to assess the value of RDW as a predictor of postoperative complications in children after cardiac surgeries. Methods Three hundred fifty-five pediatric patients who underwent cardiac surgery between 2017 and 2018 were enrolled, and preoperative and postoperative RDW values were determined. Data collected included demographics; incidence of postsurgical complications, including sepsis, surgical site infections (SSIs), urinary tract infections (UTIs), and ventilator-associated pneumonia (VAP); length of hospital and pediatric cardiac intensive care unit (PCICU) stay; and ventilator duration. Results Among children who underwent cardiac surgery, 29 (8.2%) of the cases developed bloodstream infections (BSIs), while urinary tract infections (UTIs) were observed in 32 (9.0%) of the cases, and ventilator-associated pneumonia (VAP) was observed in 36 of the cases (10.1%). Of all cases, surgical site infections (SSIs) were reported in 13 patients (3.7%). Significantly higher postoperative RDW levels were observed on days three (p-value=0.028), five (p-value=0.041), and seven (p-value=0.042) in cases of BSI. For UTI cases, only preoperative RDW levels (p<0.001) and postoperative day three RDW levels (p<0.049) were significantly higher than their counterparts. VAP cases had significantly higher RDW levels pre-operatively (p-value=0.002), which was also observed in postoperative RDW levels on days three (p-value=0.033), five (p-value=0.031), and seven (p-value=0.021) in comparison to their analogs (p-values<0.05). Furthermore, a significant relationship was found between preoperative RDW and length of intensive care unit (ICU) stay (95% CI 0.685-3.221, p-value=0.003, R2=0.104) and duration of mechanical ventilation (95% CI 0.549-1.938, p-value=0.001, R2=0.102). Conclusion RDW is a significant factor in predicting complications in pediatric patients' post-cardiac surgeries, including BSI, UTI, and VAP, which would consequently anticipate patients' clinical state after cardiac procedures.
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Zhou J, Feng L, Zhang Y, Huang S, Jiang H, Wang W. High red blood cell distribution width is associated with the mortality of critically ill cancer patients: A propensity-matching study. ADV CLIN EXP MED 2023; 32:31-41. [PMID: 36226693 DOI: 10.17219/acem/152635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/10/2022] [Accepted: 08/05/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The red blood cell distribution width (RDW) is related to the mortality of patients with malignant tumors, but the relationship between RDW and the prognosis of cancer patients in the intensive care unit (ICU) has not been fully clarified. OBJECTIVES To investigate the role of RDW in predicting the prognosis of critically ill cancer patients. MATERIAL AND METHODS A propensity score matching (PSM) study was conducted using data from adult patients with cancer, admitted to the ICU from the Intensive Care Medical Information Market IV (MIMIC-IV, v. 1.4) database. The correlation between RDW and ICU all-cause mortality was evaluated using a logistic regression model; stratification factors were considered. Additionally, a receiver operating characteristic (ROC) curve analysis was performed to compare the prognostic values of various blood biomarkers. RESULTS Overall, 4836 cancer patients were included. The optimal critical RDW value was 15%. The RDW levels were independently correlated with ICU mortality in critically ill cancer patients, with odds ratios (ORs) of 1.56 (1.12-2.18) in the original cohort, 1.64 (1.27-2.12) in the imputation cohort, 1.65 (1.22-2.24) in the matched cohort, and 1.55 (1.19-2.03) in the weighted cohort. The forecasted performance of RDW is better than other blood biomarkers with an area under the ROC curve (AUC) of 0.637 (0.591-0.683). CONCLUSIONS The RDW has a prognostic value in critically ill cancer patients and a high RDW is independently associated with high mortality.
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Affiliation(s)
- Jiahao Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, China
| | - Linya Feng
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, China
| | - Yan Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, China
| | | | - Hao Jiang
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, China
| | - Weijian Wang
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, China
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Zhao L, Zhang Y, Lin P, Li W, Huang X, Li H, Xia M, Chen X, Zhu X, Tang X. Postoperative red blood cell distribution width predicts functional outcome in aneurysmal subarachnoid hemorrhage after surgical clipping: A single-center retrospective study. Front Neurol 2022; 13:1036433. [PMID: 36619907 PMCID: PMC9817139 DOI: 10.3389/fneur.2022.1036433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Red blood cell (RBC) parameters are associated with outcomes following aneurysmal subarachnoid hemorrhage (aSAH), but their predictive value remains uncertain. This study aimed to detect the association between RBC parameters and functional outcome in aSAH patients undergoing surgical clipping. Methods This retrospective observational study included aSAH patients who underwent surgical clipping at Affiliated Hospital of North Sichuan Medical College between August 2016 and September 2019. The functional outcome following aSAH was assessed by modified Rankin Scale (mRS), and mRS 3-6 was defined as poor functional outcome. Results Out of 187 aSAH patients included (62% female, 51-66 years old), 73 patients had poor functional outcome. Multivariate logistic regression of admission parameters showed that World Federation of Neurosurgical Societies (WFNS) grade (odds ratio [95% CI]: 1.322 [1.023-1.707], p = 0.033) and white blood cell (WBC) (odds ratio [95% CI]: 1.136 [1.044-1.236], p = 0.003) were independently associated with poor functional outcome. In postoperative parameters, RBC distribution width (RDW) (odds ratio [95% CI]: 1.411 [1.095-1.818], p = 0.008), mean platelet volume (MPV, odds ratio [95% CI]: 1.253 [1.012-1.552], p = 0.039) and admission WFNS grade (odds ratio [95% CI]: 1.439 [1.119-1.850], p = 0.005) were independently associated with poor functional outcome. The predictive model including WFNS grade, admission WBC, and postoperative RDW and MPV had significantly higher predictive power compared to WFNS grade alone (0.787 [0.722-0.852] vs. 0.707 [0.630-0.784], p = 0.024). The combination of WFNS grade and WBC on admission showed the highest positive predictive value (75.5%) and postoperative RDW and MPV combined with admission WFNS grade and WBC showed the highest negative predictive value (83.7%). Conclusion Postoperative RDW is independently associated with poor functional outcome in aSAH patients undergoing surgical clipping. A combined model containing postoperative RDW may help predict good outcome in patients with aSAH after timely aneurysm clipping.
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Affiliation(s)
- Long Zhao
- Department of Neurosurgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China,School of Clinical Medicine, North Sichuan Medical College, Nanchong, China,Neurosurgical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yi Zhang
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Ping Lin
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Weida Li
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Xingyuan Huang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Hangyang Li
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Mingkai Xia
- School of Medical Imaging, North Sichuan Medical College, Nanchong, China
| | - Xinlong Chen
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Xi Zhu
- Outpatient Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, China,*Correspondence: Xi Zhu ✉
| | - Xiaoping Tang
- Department of Neurosurgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China,Neurosurgical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China,Xiaoping Tang ✉
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Hua R, Liu X, Yuan E. Red blood cell distribution width at admission predicts outcome in critically ill patients with kidney failure: a retrospective cohort study based on the MIMIC-IV database. Ren Fail 2022; 44:1182-1191. [PMID: 35834358 PMCID: PMC9291648 DOI: 10.1080/0886022x.2022.2098766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
PURPOSE We aimed to explore whether red blood cell distribution width (RDW) could serve as a biomarker to predict outcomes in critically ill patients with kidney failure in this study. MATERIALS AND METHODS This retrospective study was conducted with the Medical Information Mart for Intensive Care IV (MIMIC-IV).A total of 674 patients were divided into three groups based on tertiles of RDW. We used the generalized additive model, Kaplan-Meier curve, and Cox proportional hazards models to evaluate the association between RDW and clinical outcomes. We then performed subgroup analyses to investigate the stability of the associations between RDW and all-cause mortality. RESULTS Nonlinear and J-shaped curves were observed in the generalized additive model. Kaplan-Meier analysis showed that patients with elevated RDW had a lower survival rate. The Cox regression model indicated that high levels of RDW were most closely associated with ICU mortality and 30-day mortality (HR = 4.71, 95% CI: 1.69-11.64 and HR = 6.62, 95% CI: 2.84-15.41). Subgroup analyses indicated that the associations between RDW and all-cause mortality were stable. CONCLUSIONS Elevated levels of RDW were associated with an increased risk of all-cause mortality, and RDW could be an independent prognostic factor for kidney failure.
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Affiliation(s)
- Rongqian Hua
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuefang Liu
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Enwu Yuan
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Qin T, Liao L, Pinhu L. CORRELATION BETWEEN RED BLOOD CELL DISTRIBUTION WIDTH-TO-PLATELET RATIO AND MORTALITY IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME: A RETROSPECTIVE COHORT STUDY. Shock 2022; 58:498-506. [PMID: 36548641 DOI: 10.1097/SHK.0000000000002016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Background: This study aims to assess the prognostic value of red blood cell distribution width-to-platelet ratio (RPR) in acute respiratory distress syndrome (ARDS) patients. Methods: The data collected from 540 ARDS patients from 2001 to 2012 were obtained from the Medical Information Mart for Intensive Care III Database. The 28-day all-cause mortality risk was considered as the primary outcome parameter, and the secondary outcomes were 60- and 90-day all-cause mortality. The association between RPR (≥0.19 vs. <0.19) and mortality was assessed by Cox proportional hazards models, and potential nonlinear associations were assessed by restricted cubic spline regression analysis. Results: The 28-day all-cause mortality was 22.4%. Among the 121 deaths, 92 (20.0%) presented with an RPR <0.19, and 29 patients had RPR ≥0.19 ( P < 0.001). The 60- and 90-day all-cause mortality was 27% and 28.7%, respectively. After adjusting for the relevant factors in the multivariate model, RPR ≥0.19 was independently correlated with the 28-day all-cause mortality (hazard ratio, 2.74; 95% confidence interval, 1.46-5.15; P = 0.002). There was no nonlinear relationship between RPR and the risk of 28-day all-cause mortality ( P for overall association <0.001, P for nonlinear = 0.635). Similar results were observed for both the pneumonia and nonpneumonia subgroups and sensitivity analyses. Conclusions: The data promote the use of RPR as a valuable prognostic indicator for ARDS patients.
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Xie KH, Liu LL, Liang YR, Su CY, Li H, Liu RN, Chen QQ, He JS, Ruan YK, He WK. Red cell distribution width: a novel predictive biomarker for stroke risk after transient ischaemic attack. Ann Med 2022; 54:1167-1177. [PMID: 35471128 PMCID: PMC9045760 DOI: 10.1080/07853890.2022.2059558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Predicting the prognosis of transient ischaemic attack (TIA) is difficult for many frontline clinicians. The purpose of this study was to determine whether subsequent stroke in TIA patients can be predicted via red blood cell distribution width (RDW). MATERIAL AND METHODS A total of 360 consecutive patients with new-onset TIA in our stroke centre, were enrolled over the period studied. The patients were divided into three groups: 103 TIA patients, 206 ischaemic stroke (IS) patients and 51 patients with haemorrhagic stroke (HS) within 7 days after TIA. Complete blood count, biochemical parameters and brain imaging were performed on all patients. RESULTS The mean RDW values of patients with IS and HS after TIA were significantly higher than patients with TIA (13.35 ± 1.59 vs 12.84 ± 1.19, 13.32 ± 1.08 vs 12.84 ± 1.19, respectively, all p ≤ .001). In a multivariate model, RDW was independently associated with stroke after TIA (IS: odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.46-3.35, p = .002; HS: OR = 1.511, 95% CI = 1.101-2.074, p = .011). Compared to ABCD2 scores, the diagnostic power of RDW in the differentiation of patients with IS after TIA was better (area under curve (AUC): 0.731 vs 0.613, p = .015). When an RDW cut-off value of 13.95% was accepted for differentiating patients with IS from TIA, the sensitivity and specificity were 73.7% and 74.3%, respectively. However, the AUC for the ability of the RDW to predict HS was 0.653 (95% CI = 0.589-0.716; p < .001). CONCLUSIONS The early determination of RDW is a promising, rapid, easy and inexpensive biomarker to predict the subsequent stroke in TIA patients, especially for IS. KEY MESSAGESThe most important result of our study is to show that (1) the higher RDW, the earlier the stroke onset and (2) RDW ≥13.95% has a 2.52-fold risk of ischaemic stroke in TIA patients, and RDW ≥12.85% has a 1.51-fold risk of haemorrhagic stroke.As an economic and accessible hematological marker, baseline RDW may serve as a useful biomarker for risk stratification in TIA patients.
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Affiliation(s)
- Ke-Hang Xie
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Ling-Ling Liu
- Department of Nephrology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Yun-Ru Liang
- Reproductive Endocrine Center, Yangjiang Hospital of Traditional Chinese Medicine, Yangjiang, China
| | - Chu-Yin Su
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Hua Li
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Run-Ni Liu
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Qing-Qing Chen
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Jia-Sheng He
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Yong-Kun Ruan
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Wang-Kai He
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
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Cao W, Shao Y, Wang N, Jiang Z, Yu S, Wang J. Pretreatment red blood cell distribution width may be a potential biomarker of prognosis in urologic cancer: a systematic review and meta-analysis. Biomark Med 2022; 16:1289-1300. [PMID: 36912229 DOI: 10.2217/bmm-2022-0409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Purpose: To demonstrate the prognostic value of pretreatment red blood cell distribution width (RDW) in patients with urological cancer. Methods: We searched the relevant literature on Web of Science, Cochrane Central Register of Controlled Trials, PubMed, Embase, Sinomed databases and Chinese National Knowledge Infrastructure up to 30 March 2022, to investigate the relationship between RDW levels and the prognosis of patients with urological tumors. Results: This study comprised 15 retrospective studies involving 9492 patients. Increased pretreatment RDW was associated with poorer overall survival (hazard ratio [HR]: 1.52; 95% CI: 1.27-1.82; p < 0.001), cancer-specific survival (HR: 1.34; 95% CI: 1.15-1.57; p < 0.001) and progression-free survival (HR: 1.53; 95% CI: 1.26-1.86; p < 0.001). Conclusion: High pretreatment RDW might predict poor survival for patients with urologic cancers.
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Affiliation(s)
- Wei Cao
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Yifeng Shao
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Na Wang
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Zhichao Jiang
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Sun Yu
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Jinguo Wang
- The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
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Golriz M, Ramouz A, Ali-Hasan-Al-Saegh S, Shafiei S, Aminizadeh E, Hammad A, Mieth M, Rupp C, Springfeld C, Hoffmann K, Büchler M, Mehrabi A. Prognostic Value of Red Blood Cell Distribution Width (RDW) in the Recurrence of Hepatocellular Carcinoma Following Curative Resection. J Hepatocell Carcinoma 2022; 9:1137-1147. [PMID: 36338431 PMCID: PMC9635388 DOI: 10.2147/jhc.s380243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose Although surgery is associated with an acceptable cure rate, tumor recurrence is still a challenging issue in hepatocellular carcinoma (HCC) patients. Red blood cell distribution width (RDW) is considered an inflammatory marker for predicting overall mortality in a wide spectrum of malignancies. In the current study, the prognostic role of pre- and postoperative RDW in HCC recurrence after liver resection (LRx) is investigated. Patients and Methods In 395 patients, RDW levels were evaluated preoperatively as well as six and twelve months after curative LRx. The RDW cutoff values were determined using receiver operating characteristic curves (ROCs) according to the recurrence-free survival (RFS). Survival analyses were performed using the Kaplan-Meier, and differences were compared using the Log rank test. Results The RFS was significantly higher among patients with low RDW at the 6th month and 12th month, postoperatively (P < 0.001 and P = 0.028). RDW levels of higher than 16.15% at the 6th (HR: 2.047, P <0.001) and higher than 15.85% at 12th (HR: 3.105, P < 0.002) months after liver resection were independent predictors of RFS. Conclusion Postoperative RDW values seem to be predictive of tumor recurrence in HCC patients. RDW levels at the 6th and 12th months postoperatively were independent predictors of recurrence after LRx.
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Affiliation(s)
- Mohammad Golriz
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Ali Ramouz
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Sadeq Ali-Hasan-Al-Saegh
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Saeed Shafiei
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Ehsan Aminizadeh
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Ahmed Hammad
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Markus Mieth
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Christian Rupp
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,Department of Internal Medicine IV, Gastroenterology & Hepatology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Christoph Springfeld
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,National Center for Tumor Diseases, Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Katrin Hoffmann
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Markus Büchler
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany,Correspondence: Arianeb Mehrabi, Head of the Division of Liver Surgery and Visceral Transplantation, Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany, Tel +49–6221–5636223, Fax +49–6221–567470, Email
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Cao W, Ren H, Song B, Liao Z, Li H. Red cell distribution width and Glasgow coma scale score as predictors of in-hospital mortality in maintenance hemodialysis patients diagnosed with spontaneous intracerebral hemorrhage. Medicine (Baltimore) 2022; 101:e31094. [PMID: 36281123 PMCID: PMC9592290 DOI: 10.1097/md.0000000000031094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Glasgow Coma Scale (GCS) score is being widely used as a useful predictor to investigate patients with head injury. High red cell distribution width (RDW) values have been independently associated with mortality and poor neurological outcome. However, there are few data available for Spontaneous Intracerebral Hemorrhage (SIH) in maintenance hemodialysis (MHD) patients. This study aimed to evaluate the prognostic value of the combined measurement of RDW and GCS score in MHD patients with SIH. We retrospectively studied 46 MHD patients who was admitted to our hospital for nontraumatic SIH from October 2014 to May 2020. Data including demographic information, cause of renal failure, comorbidities at ESRD, clinical and laboratory parameters at admission were collected from medical records. Univariate and multivariate Logistic regression analysis were performed to identify independent risk factors of the in-hospital Mortality in Hemodialysis Patients with SIH. The receiver operating characteristic curve (ROC) and areas under the curve (AUCs) were determined. The sensitivity and specificity of independent risk factors were calculated for a range of different cutoff points. A total of 46 patients were enrolled in the study. The in-hospital mortality rate was 69.57%. We divided subjects into 2 groups based on the clinical outcomes. Compared with survivors (n = 14), non-survivors (n = 32) had longer hemodialysis vintage (P = .017), lower GCS score (P < .001), higher hemoglobin (Hb) (P = .032) and RDW (P = .009). In multivariate logistic regression analysis, GCS score (OR 0.719, 95% CI 0.546-0.946; P = .018) and RDW (OR 4.549, 95% CI 1.243-0.946; P = .018) were independent risk factors of in-hospital mortality in MHD patients with SIH. The area under the ROC curve (AUC) for GCS score was 0.849 (95% CI 0.729-0.970) while that for RDW was 0.743 (95% CI 0.596-0.891). The AUC for the combined prediction was 0.916 (95% CI 0.828-1.000), with a sensitivity of 90.63% and a specificity of 88.46%. In conclusion, high RDW and low GCS score were useful and independent poor prognostic markers for in-hospital mortality of MHD patients with SIH.
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Affiliation(s)
- Wen Cao
- Department of Nephrology, People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Haoyuan Ren
- Department of Gastrointestinal Surgery, People’s Hospital of Deyang City, Deyang, Sichuan, China
- *Correspondence: Haoyuan Ren, Department of Gastrointestinal Surgery, People’s Hospital of Deyang City, Deyang 618000, Sichuan, China (e-mail: )
| | - Bin Song
- Department of Nephrology, People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Zuchun Liao
- Department of Nephrology, People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Haiyan Li
- Department of Nephrology, People’s Hospital of Deyang City, Deyang, Sichuan, China
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Liu J, Chou EL, Lau KK, Woo PYM, Wan TK, Huang R, Chan KHK. A Mendelian randomization-based exploration of red blood cell distribution width and mean corpuscular volume with risk of hemorrhagic strokes. HGG Adv 2022; 3:100135. [PMID: 36051507 PMCID: PMC9424589 DOI: 10.1016/j.xhgg.2022.100135] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/03/2022] [Indexed: 10/31/2022] Open
Abstract
Red blood cell distribution width (RCDW) and mean corpuscular volume (MCV) are associated with different risk factors for hemorrhagic stroke. However, whether RCDW and MCV are causally related to hemorrhagic stroke remains poorly understood. Therefore, we explored the causality between RCDW/MCV and nontraumatic hemorrhagic strokes using Mendelian randomization (MR) methods. We extracted exposure and outcome summary statistics from the UK Biobank and FinnGen. We evaluated the causality of RCDW/MCV on four outcomes (subarachnoid hemorrhage [SAH], intracerebral hemorrhage [ICH], nontraumatic intracranial hemorrhage [nITH], and a combination of SAH, cerebral aneurysm, and aneurysm operations) using univariable MR (UMR) and multivariable MR (MVMR). We further performed colocalization and mediation analyses. UMR and MVMR revealed that higher genetically predicted MCV is protective of ICH (UMR: odds ratio [OR] = 0.89 [0.8-0.99], p = 0.036; MVMR: OR = 0.87 [0.78-0.98], p = 0.021) and nITH (UMR: OR = 0.89 [0.82-0.97], p = 0.005; MVMR: OR = 0.88 [0.8-0.96], p = 0.004). There were no strong causal associations between RCDW/MCV and any other outcome. Colocalization analysis revealed a shared causal variant between MCV and ICH; it was not reported to be associated with ICH. Proportion mediated via diastolic blood pressure was 3.1% (0.1%,14.3%) in ICH and 3.4% (0.2%,15.8%) in nITH. The study constitutes the first MR analysis on whether genetically elevated RCDW and MCV affect the risk of hemorrhagic strokes. UMR, MVMR, and mediation analysis revealed that MCV is a protective factor for ICH and nITH, which may inform new insights into the treatments for hemorrhagic strokes.
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Affiliation(s)
- Jundong Liu
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
| | | | - Kui Kai Lau
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | | | - Tsz Kin Wan
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Ruixuan Huang
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Kei Hang Katie Chan
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China.,Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR, China.,Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, RI, USA
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