Increased red cell distribution width: A novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease
Increased red cell distribution width: A novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease
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DOI：
10.1016/j.rmed.2018.01.011
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发表时间：
2018-03-01
影响因子：
4.3
通讯作者：
Berger, Gidon
中科院分区：
文献类型：
--
作者：
Epstein, Danny;Nasser, Roni;Berger, Gidon
背景：慢性阻塞性肺病急性加重（AECOPD）是发达国家住院和再入院的主要原因之一。没有一致发现与再入院风险相关的实验室指标。最近的证据证明，红细胞分布宽度（RDW）在各种医疗条件下传递了短期和长期预后的重要信息。RDW对AECOPD患者预后的有用性尚未研究。目的：评价RDW在预测AECOPD住院患者早期不良结局中的应用价值。方法：对2011 - 2013年住院的AECOPD患者进行回顾性分析。记录临床和实验室参数。随访参与者以确定出院后60天内因AECOPD再入院的发生率、任何原因再入院的发生率以及再入院或死亡的复合终点。结果：539例患者纳入研究。60天总再入院率为26.35%，其中41.55%为AECOPD所致。心力衰竭、出院时pH值低于7.35、RDW异常与复合终点相关。正常RDW阴性预测值为80.12%。结论：RDW升高是与AECOPD住院后不良结局相关的独立不良预后因素。
Background: Acute exacerbation of COPD ( AECOPD) is one of the leading causes for hospitalization and readmission in developed countries. No laboratory indices were consistently found to be associated with readmission risk. Recent evidence attests that red blood cell distribution width ( RDW), conveys important information for short and long term prognosis in a variety of medical conditions. Prognostic usefulness of RDW in patients with AECOPD has not been investigated.Objective: To evaluate the usefulness of RDW in predicting early adverse outcomes in patients hospitalized due to AECOPD.Methods: Patients hospitalized for AECOPD between 2011 and 2013 were revised. Clinical and laboratory parameters were noted. Participants were followed to determine the incidence of readmission due to AECOPD, readmission from any cause and composite end point of readmission or death during 60 days after discharge.Results: 539 patients were included in the study. The 60-day overall readmission rate was 26.35%, of that, 41.55% were due to AECOPD. The Presence of heart failure, pH below 7.35 at discharge and abnormal RDW were associated with the composite endpoint. The negative predictive value of normal RDW was 80.12%.Conclusion: Increased RDW is an independent negative prognostic factor associated with adverse outcomes after hospitalization due to AECOPD.