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

Authors
 Namki Hong  ;  Jaewon Oh  ;  Seok-Min Kang  ;  Soo-Young Kim  ;  Hoyoun Won  ;  Jong Chan Youn  ;  Sungha Park  ;  Yangsoo Jang  ;  Namsik Chung 
Citation
 CLINICA CHIMICA ACTA, Vol.413(11-12) : 992-997, 2012 
Journal Title
 CLINICA CHIMICA ACTA 
ISSN
 0009-8981 
Issue Date
2012
MeSH
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Dyspnea/blood* ; Dyspnea/mortality* ; Erythrocyte Indices* ; Female ; Heart Failure/mortality ; Humans ; Male ; Middle Aged ; Neoplasms/diagnosis ; Pneumonia/diagnosis ; Predictive Value of Tests ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Time Factors
Keywords
Dyspnea ; Mortality ; Red blood cell distribution width
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0009898112001064
DOI
22406179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, Soo Young(김수영) ORCID logo https://orcid.org/0000-0002-8919-3456
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Won, Ho Youn(원호연)
Youn, Jong Chan(윤종찬)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89980
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