engleski

Red cell distribution width in acute pulmonary embolism patients: a simple aid for improvement of the 30-day mortality risk stratification based on the pulmonary embolism severity index

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. Retrospective analysis of consecutive adult PE patients. 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.

30-day mortality ; acute pulmonary embolism ; pulmonary embolism severity index ; red cell distribution width

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