Gianni Turcato1, Elisabetta Zorzi2, Daniele Prati3, Giorgio Ricci4, Antonio Bonora4, Massimo Zannoni4, Antonio Maccagnani4, Gian Luca Salvagno5, Fabian Sanchis-Gomar6, Gianfranco Cervellin7, Giuseppe Lippi5. 1. Department of Emergency Medicine, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy. Electronic address: gianni.turcato@yahoo.it. 2. Department of Cardiology and Intensive Care Cardiology, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy. 3. Department of Cardiology and Intensive Care Cardiology, University of Verona, Verona, Italy. 4. Department of Emergency Medicine, University of Verona, Verona, Italy. 5. Section of Clinical Biochemistry, University of Verona, Verona, Italy. 6. Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, USA; Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario de Valencia, Instituto de Investigación INCLIVA, Valencia, Spain. 7. Department of Emergency Medicine, Academic Hospital of Parma, Parma, Italy.
Abstract
BACKGROUND: Some studies showed that the value of red blood cell distribution width (RDW) at admission may predict clinical outcomes in patients with acutely decompensated heart failure (ADHF). Therefore, this study was planned to investigate whether in-hospital variations of RDW may also predict mortality in this condition. METHODS: The final study population consisted of 588 patients admitted to the local Emergency Department (ED), who were hospitalized for ADHF. The RDW was measured at ED admission and after 48h and 96h of hospital stay. In-hospital variations from admission value, expressed as absolute variation (DeltaRDW) or percent variation (Delta%RDW), were then correlated with 30- and 60-day mortality. RESULTS: Overall, 87 (14.8%) and 118 (20.1%) patients with ADHF died at 30 or 60days of follow-up. Delta%RDW after 96h of hospital stay independently predicted 30-day mortality (odds ratio, 1.12; 95% CI, 1.07-1.18). An increase >1% of Delta%RDW after 96h of hospital stay independently predicted both 30-day (odds ratio, 2.86; 95% CI, 1.67-4.97) and 60-day (odds ratio, 3.06; 95% CI, 1.89-4.96) mortality. A similar trend was observed for DeltaRDW, since an increase after 96h of hospital stay was associated with a nearly 4-fold higher 30-day mortality (odds ratio, 3.65; 95% CI, 2.02-6.15). CONCLUSION: Despite it remains unclear whether RDW is a real risk factor or an epiphenomenon in ADHF, these results suggest that more aggressive management may be advisable in ADHF patients with increasing anisocytosis during the first days of hospitalization.
BACKGROUND: Some studies showed that the value of red blood cell distribution width (RDW) at admission may predict clinical outcomes in patients with acutely decompensated heart failure (ADHF). Therefore, this study was planned to investigate whether in-hospital variations of RDW may also predict mortality in this condition. METHODS: The final study population consisted of 588 patients admitted to the local Emergency Department (ED), who were hospitalized for ADHF. The RDW was measured at ED admission and after 48h and 96h of hospital stay. In-hospital variations from admission value, expressed as absolute variation (DeltaRDW) or percent variation (Delta%RDW), were then correlated with 30- and 60-day mortality. RESULTS: Overall, 87 (14.8%) and 118 (20.1%) patients with ADHF died at 30 or 60days of follow-up. Delta%RDW after 96h of hospital stay independently predicted 30-day mortality (odds ratio, 1.12; 95% CI, 1.07-1.18). An increase >1% of Delta%RDW after 96h of hospital stay independently predicted both 30-day (odds ratio, 2.86; 95% CI, 1.67-4.97) and 60-day (odds ratio, 3.06; 95% CI, 1.89-4.96) mortality. A similar trend was observed for DeltaRDW, since an increase after 96h of hospital stay was associated with a nearly 4-fold higher 30-day mortality (odds ratio, 3.65; 95% CI, 2.02-6.15). CONCLUSION: Despite it remains unclear whether RDW is a real risk factor or an epiphenomenon in ADHF, these results suggest that more aggressive management may be advisable in ADHF patients with increasing anisocytosis during the first days of hospitalization.
Authors: Gianni Turcato; Gianfranco Cervellin; Antonio Bonora; Danieli Prati; Elisabetta Zorzi; Giorgio Ricci; Gian Luca Salvagno; Antonio Maccagnani; Giuseppe Lippi Journal: J Med Biochem Date: 2018-07-01 Impact factor: 3.402
Authors: Gian Franco Veraldi; Luca Mezzetto; Lorenzo Scorsone; Marco Macrì; Fabio Simoncini; Giuseppe Lippi Journal: J Med Biochem Date: 2019-07-30 Impact factor: 3.402