Elevated Red blood cell distribution width predicts mortality in acute exacerbation of COPD

Red blood cell distribution width (RDW) has
been shown to predict clinical outcomes in many diseases.
To our knowledge, the prognostic significance of RDW
in acute exacerbation of chronic obstructive pulmonary
disease (AECOPD) has not been reported so far. The aim
of the present study is to investigate the relation of RDW
to in-hospital mortality in patients with AECOPD.
Methods: We retrospectively reviewed hospital records
of inpatients with AECOPD in two referral teaching
hospitals in two provinces of east Azerbaijan and west
Azerbaijan, Iran. Associations between RDW and inhospital
death were analyzed with using correlation,
logistic regression analysis, and receiver operating
characteristic (ROC) curves in SPSS software.
Results: We studied 330 patients, of whom 75 (22.7%)
did not survive to hospital discharge. In univariate
analysis higher RDW-SD values were associated with
increased hospital mortality (30.2% vs. 15.8% p=0.002
odds ratio 2.31). Using the first quartile of RDW as
reference, odds ratio (OR) mortality among patients
in the highest RDW quartile was 5.34 (95% CI, 2.70-
12.57; p = 0.001). In multivariate analysis RDW-SD
remained an independent risk factor for mortality
after correction for age, thrombocytopenia, leukocyte
count, mean corpuscular volume, anemia. In receiveroperating
curve analysis the AUC for RDW was 0.663,
which was more than that of hemoglobin, platelets.
Conclusion: RDW on admission day proves to be a
useful indicator to predict in-hospital death in AECOPD