Red blood cell distribution width predicts early mortality in patients with acute dyspnea

Namki Hong, Jaewon Oh, Seok Min Kang, Soo Young Kim, Hoyoun Won, Jong Chan Youn, Sungha Park, Yangsoo Jang, Namsik Chung

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Red blood cell distribution width (RDW) has been shown to predict clinical outcomes in cardiovascular diseases. We studied whether RDW is useful to predict early mortality in patients with acute dyspnea at an emergency department (ED). Methods: We retrospectively analyzed 907 patients with acute dyspnea who visited the ED from January 2009 to May 2009. Primary outcome was 30-day mortality. Results: Acute decompensated heart failure (29.9%) was the most common adjudicated discharge diagnosis followed by cancer (14.8%) and pneumonia (12.5%). There was a stepwise increase of 30-day mortality risk from lowest (RDW. <. 12.9%) to highest (RDW. >. 14.3%) RDW tertiles (1.4% vs. 8.3% vs. 18.3%; log-rank P. <. 0.001). In multivariate Cox hazard analysis, RDW was an independent predictor of 30-day mortality after adjusting for other risk factors (HR 1.23; 95% CI 1.11-1.36; P. <. 0.001). Adding RDW to conventional clinical predictors significantly improved prediction for 30-day mortality as measured by the area under the ROC curve (AUC, from 0.873 to 0.885; P. =. 0.023) and the net reclassification improvement (NRI. =. 14.1%; P. <. 0.001)/integrated discrimination improvement (IDI. =. 0.038; P. =. 0.006). Conclusions: Our findings suggest that RDW measured at ED is an independent and additive predictor of early mortality in patients with acute dyspnea.

Original languageEnglish
Pages (from-to)992-997
Number of pages6
JournalClinica Chimica Acta
Volume413
Issue number11-12
DOIs
Publication statusPublished - 2012 Jun 14

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Erythrocyte Indices
Dyspnea
Blood
Erythrocytes
Cells
Mortality
Hospital Emergency Service
Hazards
Area Under Curve
ROC Curve
Pneumonia
Cardiovascular Diseases
Heart Failure
Neoplasms

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Hong, Namki ; Oh, Jaewon ; Kang, Seok Min ; Kim, Soo Young ; Won, Hoyoun ; Youn, Jong Chan ; Park, Sungha ; Jang, Yangsoo ; Chung, Namsik. / Red blood cell distribution width predicts early mortality in patients with acute dyspnea. In: Clinica Chimica Acta. 2012 ; Vol. 413, No. 11-12. pp. 992-997.
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abstract = "Background: Red blood cell distribution width (RDW) has been shown to predict clinical outcomes in cardiovascular diseases. We studied whether RDW is useful to predict early mortality in patients with acute dyspnea at an emergency department (ED). Methods: We retrospectively analyzed 907 patients with acute dyspnea who visited the ED from January 2009 to May 2009. Primary outcome was 30-day mortality. Results: Acute decompensated heart failure (29.9{\%}) was the most common adjudicated discharge diagnosis followed by cancer (14.8{\%}) and pneumonia (12.5{\%}). There was a stepwise increase of 30-day mortality risk from lowest (RDW. <. 12.9{\%}) to highest (RDW. >. 14.3{\%}) RDW tertiles (1.4{\%} vs. 8.3{\%} vs. 18.3{\%}; log-rank P. <. 0.001). In multivariate Cox hazard analysis, RDW was an independent predictor of 30-day mortality after adjusting for other risk factors (HR 1.23; 95{\%} CI 1.11-1.36; P. <. 0.001). Adding RDW to conventional clinical predictors significantly improved prediction for 30-day mortality as measured by the area under the ROC curve (AUC, from 0.873 to 0.885; P. =. 0.023) and the net reclassification improvement (NRI. =. 14.1{\%}; P. <. 0.001)/integrated discrimination improvement (IDI. =. 0.038; P. =. 0.006). Conclusions: Our findings suggest that RDW measured at ED is an independent and additive predictor of early mortality in patients with acute dyspnea.",
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Red blood cell distribution width predicts early mortality in patients with acute dyspnea. / Hong, Namki; Oh, Jaewon; Kang, Seok Min; Kim, Soo Young; Won, Hoyoun; Youn, Jong Chan; Park, Sungha; Jang, Yangsoo; Chung, Namsik.

In: Clinica Chimica Acta, Vol. 413, No. 11-12, 14.06.2012, p. 992-997.

Research output: Contribution to journalArticle

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T1 - Red blood cell distribution width predicts early mortality in patients with acute dyspnea

AU - Hong, Namki

AU - Oh, Jaewon

AU - Kang, Seok Min

AU - Kim, Soo Young

AU - Won, Hoyoun

AU - Youn, Jong Chan

AU - Park, Sungha

AU - Jang, Yangsoo

AU - Chung, Namsik

PY - 2012/6/14

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N2 - Background: Red blood cell distribution width (RDW) has been shown to predict clinical outcomes in cardiovascular diseases. We studied whether RDW is useful to predict early mortality in patients with acute dyspnea at an emergency department (ED). Methods: We retrospectively analyzed 907 patients with acute dyspnea who visited the ED from January 2009 to May 2009. Primary outcome was 30-day mortality. Results: Acute decompensated heart failure (29.9%) was the most common adjudicated discharge diagnosis followed by cancer (14.8%) and pneumonia (12.5%). There was a stepwise increase of 30-day mortality risk from lowest (RDW. <. 12.9%) to highest (RDW. >. 14.3%) RDW tertiles (1.4% vs. 8.3% vs. 18.3%; log-rank P. <. 0.001). In multivariate Cox hazard analysis, RDW was an independent predictor of 30-day mortality after adjusting for other risk factors (HR 1.23; 95% CI 1.11-1.36; P. <. 0.001). Adding RDW to conventional clinical predictors significantly improved prediction for 30-day mortality as measured by the area under the ROC curve (AUC, from 0.873 to 0.885; P. =. 0.023) and the net reclassification improvement (NRI. =. 14.1%; P. <. 0.001)/integrated discrimination improvement (IDI. =. 0.038; P. =. 0.006). Conclusions: Our findings suggest that RDW measured at ED is an independent and additive predictor of early mortality in patients with acute dyspnea.

AB - Background: Red blood cell distribution width (RDW) has been shown to predict clinical outcomes in cardiovascular diseases. We studied whether RDW is useful to predict early mortality in patients with acute dyspnea at an emergency department (ED). Methods: We retrospectively analyzed 907 patients with acute dyspnea who visited the ED from January 2009 to May 2009. Primary outcome was 30-day mortality. Results: Acute decompensated heart failure (29.9%) was the most common adjudicated discharge diagnosis followed by cancer (14.8%) and pneumonia (12.5%). There was a stepwise increase of 30-day mortality risk from lowest (RDW. <. 12.9%) to highest (RDW. >. 14.3%) RDW tertiles (1.4% vs. 8.3% vs. 18.3%; log-rank P. <. 0.001). In multivariate Cox hazard analysis, RDW was an independent predictor of 30-day mortality after adjusting for other risk factors (HR 1.23; 95% CI 1.11-1.36; P. <. 0.001). Adding RDW to conventional clinical predictors significantly improved prediction for 30-day mortality as measured by the area under the ROC curve (AUC, from 0.873 to 0.885; P. =. 0.023) and the net reclassification improvement (NRI. =. 14.1%; P. <. 0.001)/integrated discrimination improvement (IDI. =. 0.038; P. =. 0.006). Conclusions: Our findings suggest that RDW measured at ED is an independent and additive predictor of early mortality in patients with acute dyspnea.

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