Ivana Jurin1, Vladimir Trkulja2, Marko Ajduk3, Tomislav Letilović4, Irzal Hadžibegović5. 1. University Hospital Dubrava, Avenija Gojka Šuška 6, Zagreb, 10000, Croatia. Electronic address: ivanajurin1912@gmail.com. 2. Zagreb University School of Medicine, Šalata 3b, Zagreb, 10000, Croatia. Electronic address: vladimir.trkulja@mef.hr. 3. University Hospital Dubrava, Avenija Gojka Šuška 6, Zagreb, 10000, Croatia; Zagreb University School of Medicine, Šalata 3b, Zagreb, 10000, Croatia. Electronic address: majduk@kbd.hr. 4. Zagreb University School of Medicine, Šalata 3b, Zagreb, 10000, Croatia; University Hospital Merkur, Zajčeva 19, Zagreb, 10000, Croatia. Electronic address: letilovic@gmail.com. 5. University Hospital Dubrava, Avenija Gojka Šuška 6, Zagreb, 10000, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University, Osijek, Croatia. Electronic address: irzalh@gmail.com.
Abstract
BACKGROUND: Pulmonary embolism (PE) severity index (PESI) well predicts 30-day mortality in acute PE patients, yet improvements have been advocated. OBJECTIVES: To evaluate predictivity of the red cell distribution width (RDW) through a comparison with PESI and to explore their interaction as a potential improvement in this respect. METHODS: Retrospective analysis of consecutive adult PE patients. RESULTS: Of the 299 patients, 19 severely unstable died within 48 h. Among the stabilized patients, 30-day mortality was 12.1% (34/280). With PESI ≤125, mortality was 4.9% (9/185), but it was 0.7% (1/140) if RDW ≤15.0% and 17.8% (8/45) if RDW >15.0%; with PESI >125, mortality was 26.3% (25/95), but it was 15.9% (7/44) if RDW ≤15.0% and 35.3% (18/51) if RDW >15.0%. Adjusted relative risk with PESI >125 vs. ≤125 was 17.5 (95%CI 2.37-129) at RDW ≤15.0% and 1.60 (0.76-3.36) at RDW >15.0%. CONCLUSIONS: Thirty-day mortality predictions based on the PESI score may be improved by accounting for RDW.
BACKGROUND:Pulmonary embolism (PE) severity index (PESI) well predicts 30-day mortality in acute PE patients, yet improvements have been advocated. OBJECTIVES: To evaluate predictivity of the red cell distribution width (RDW) through a comparison with PESI and to explore their interaction as a potential improvement in this respect. METHODS: Retrospective analysis of consecutive adult PE patients. RESULTS: Of the 299 patients, 19 severely unstable died within 48 h. Among the stabilized patients, 30-day mortality was 12.1% (34/280). With PESI ≤125, mortality was 4.9% (9/185), but it was 0.7% (1/140) if RDW ≤15.0% and 17.8% (8/45) if RDW >15.0%; with PESI >125, mortality was 26.3% (25/95), but it was 15.9% (7/44) if RDW ≤15.0% and 35.3% (18/51) if RDW >15.0%. Adjusted relative risk with PESI >125 vs. ≤125 was 17.5 (95%CI 2.37-129) at RDW ≤15.0% and 1.60 (0.76-3.36) at RDW >15.0%. CONCLUSIONS: Thirty-day mortality predictions based on the PESI score may be improved by accounting for RDW.