G-P Hu1, Y-M Zhou2, Z-L Wu1, Y-Q Li1, W-Q Liang1, L-P Wei1, P-X Ran2. 1. Department of Respiratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong. 2. Guangzhou Institute of Respiratory Disease, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Abstract
BACKGROUND: The prognostic role of the red blood cell distribution width (RDW) on an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is incompletely understood. OBJECTIVE: To investigate the effect of the RDW on in-hospital and 1-year mortality after an AECOPD. DESIGN: For 442 AECOPD patients, the RDW was measured and clinical characteristics, comorbidities and laboratory measurements were recorded. The RDW that discriminated survivors and non-survivors was determined using a receiver operator characteristic (ROC) curve. The risk factors for in-hospital and 1-year mortality were identified through logistic regression analysis and Cox regression analysis, respectively. RESULTS: Of 442 study patients, 31 died, and 411 survived while in hospital. The area under the ROC curve for RDW for in-hospital death was 0.726 (95%CI 0.631-0.822), with sensitivity of 0.71 and specificity of 0.64 for a cut-off point of 13.75%. An RDW ≥13.75% was a risk factor for in-hospital mortality (relative risk 4.30, 95%CI 1.98-9.58; P < 0.001). Univariate and multivariate Cox regression analysis showed that an RDW ≥13.75% was an independent risk factor for death at 1 year (univariate analysis, hazard ration [HR] 2.33, 95%CI 1.55-3.51; multivariate analysis, HR 1.64, 95%CI 1.08-2.50). CONCLUSION: The RDW was a strong and independent risk factor for in-hospital and 1-year death for AECOPD patients.
BACKGROUND: The prognostic role of the red blood cell distribution width (RDW) on an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is incompletely understood. OBJECTIVE: To investigate the effect of the RDW on in-hospital and 1-year mortality after an AECOPD. DESIGN: For 442 AECOPD patients, the RDW was measured and clinical characteristics, comorbidities and laboratory measurements were recorded. The RDW that discriminated survivors and non-survivors was determined using a receiver operator characteristic (ROC) curve. The risk factors for in-hospital and 1-year mortality were identified through logistic regression analysis and Cox regression analysis, respectively. RESULTS: Of 442 study patients, 31 died, and 411 survived while in hospital. The area under the ROC curve for RDW for in-hospital death was 0.726 (95%CI 0.631-0.822), with sensitivity of 0.71 and specificity of 0.64 for a cut-off point of 13.75%. An RDW ≥13.75% was a risk factor for in-hospital mortality (relative risk 4.30, 95%CI 1.98-9.58; P < 0.001). Univariate and multivariate Cox regression analysis showed that an RDW ≥13.75% was an independent risk factor for death at 1 year (univariate analysis, hazard ration [HR] 2.33, 95%CI 1.55-3.51; multivariate analysis, HR 1.64, 95%CI 1.08-2.50). CONCLUSION: The RDW was a strong and independent risk factor for in-hospital and 1-year death for AECOPD patients.