Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer
Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer
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DOI：
10.1093/ejcts/ezt275
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发表时间：
2014-01-01
影响因子：
3.4
通讯作者：
Poullis, Michael
中科院分区：
文献类型：
--
作者：
Warwick, Richard;Mediratta, Neeraj;Poullis, Michael
目的：红细胞分布宽度（RDW）已被确定为心脏病患者预后的独立危险因素。我们试图调查RDW在非小细胞肺癌患者行肺切除术与住院期间发病率，死亡率和长期survival.METHODS的相关性：在一个经过验证的前瞻性胸外科手术数据库上进行连续患者的分析，这些患者在一个单一的机构进行潜在的根治性切除术。对术后有创和无创通气、浅表伤口感染、住院时间、住院死亡率和长期生存率进行单变量和多变量分析。结果：所有病例的总死亡率为1.9%（n = 917）。中位随访时间为6.8年。单因素分析显示，RDW对住院时间（P < 0.001）、住院死亡率（P <0.001）、术后有创和无创通气（P <0.001）、浅表伤口感染（P = 0.06）和长期生存（P < 0.0001）有显著影响。多因素分析显示RDW是决定术后有创和无创通气、浅表伤口感染、住院时间、住院死亡率和长期生存率的重要因素。混杂因素分析表明，在没有贫血，RDW仍然是一个重要因素，在上述analysis.CONCLUSIONS：RDW是一个重要因素后，风险调整，确定在医院的发病率，死亡率和长期生存的患者后潜在的根治性切除术非小细胞肺癌。需要进一步的工作来阐明RDW对住院发病率、死亡率和长期生存率影响的确切机制。我们推测骨髓功能障碍可能是一个问题。
OBJECTIVES: Red cell distribution width (RDW) has been identified as an independent risk factor with regard to prognosis in patients with cardiac disease. We sought to investigate the association of RDW in patients undergoing lung resections for non-small-cell lung cancer with respect to in-hospital morbidity, mortality and long-term survival.METHODS: Analysis of consecutive patients on a validated prospective thoracic surgery database was performed for those undergoing potentially curative resections at a single institution. Univariate and multivariate analyses were performed for postoperative invasive and non-invasive ventilation, superficial wound infections, length of hospital stay, in-hospital mortality and long-term survival.RESULTS: Overall mortality was 1.9% for all cases (n = 917). The median follow-up was 6.8 years. Univariate analysis demonstrated that RDW has a significant effect on hospital length of stay (P < 0.001), in-hospital mortality rates (P < 0.001), postoperative invasive and non-invasive ventilation (P < 0.001), superficial wound infections (P = 0.06) and long-term survival (P < 0.0001). Multivariate analysis revealed that RDW is a significant factor determining postoperative invasive and non-invasive ventilation, superficial wound infections, length of hospital stay, in-hospital mortality and long-term survival. Confounding factor analysis revealed that in the absence of anaemia, RDW was still a significant factor in the above analysis.CONCLUSIONS: RDW is a significant factor after risk adjustment, determining in-hospital morbidity, mortality and long-term survival in patients post-potentially curative resections for non-small-cell lung cancer. Further work is needed to elucidate the exact mechanism of RDW impact on in-hospital morbidity, mortality and long-term survival. We speculate that subtle bone marrow dysfunction may be an issue.