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Red blood cell distribution width predicts mortality of adult patients receiving veno-arterial extracorporeal membrane oxygenation.
- Source :
-
Perfusion . Jul2024, Vol. 39 Issue 5, p935-942. 8p. - Publication Year :
- 2024
-
Abstract
- Background: Red blood cell distribution width (RDW) is a numerical measure of the variation in the size of circulating red blood cells. Recently, there is increasing interest in the role of RDW as a biomarker for inflammatory states and as a prognostication tool for a wide range of clinical manifestations. The predictive power of RDW on mortality among patients receiving mechanical circulatory support remains largely unknown. Methods: A retrospective analysis of 281 VA-ECMO patients at a tertiary referral academic hospital from 2009 to 2019 was performed. RDW was dichotomized with RDW-Low <14.5% and RDW-High ≥14.5%. The primary outcome was all-cause mortality at 30 days and 1 year. Cox proportional hazards models were used to examine the association between RDW and the clinical outcomes after adjusting for additional confounders. Results: 281 patients were included in the analysis. There were 121 patients (43%) in the RDW-Low group and 160 patients (57%) in the RDW-High group. Survival to ECMO decannulation [RDW-H: 58% versus RDW-L: 67%, p = 0.07] were similar between the two groups. Patients in RDW-H group had higher 30-days mortality (RDW-H: 67.5% vs RDW-L: 39.7%, p < 0.001) and 1 year mortality (RDW-H: 79.4% vs RDW-L: 52.9%, p < 0.001) compared to patients in the RDW-L group. After adjusting for confounders, Cox proportional hazards model demonstrated that patients with high RDW had increased odds of mortality at 30 days (hazard ratio 1.9, 95% CI 1.2–3.0, p < 0.01) and 1 year (hazard ratio 1.9, 95% CI 1.3–2.8, p < 0.01) compared to patients with low RDW. Conclusions: Among patients receiving mechanical circulatory support with VA-ECMO, a higher RDW was independently associated with increased 30-days and 1-year mortality. RDW may serve as a simple biomarker that can be quickly obtained to help provide risk stratification and predict survival for patients receiving VA-ECMO. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RISK assessment
*ERYTHROCYTES
*EXTRACORPOREAL membrane oxygenation
*ACADEMIC medical centers
*BODY mass index
*T-test (Statistics)
*QUESTIONNAIRES
*KRUSKAL-Wallis Test
*FISHER exact test
*HEMOGLOBINS
*RETROSPECTIVE studies
*TERTIARY care
*DESCRIPTIVE statistics
*AGE distribution
*CHI-squared test
*TREATMENT duration
*BLOOD platelet transfusion
*ODDS ratio
*MEDICAL records
*ACQUISITION of data
*STATISTICS
*LACTATES
*CONVALESCENCE
*SURVIVAL analysis (Biometry)
*CONFIDENCE intervals
*DATA analysis software
*BIOMARKERS
*PROPORTIONAL hazards models
*COMORBIDITY
*ADULTS
MORTALITY risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 02676591
- Volume :
- 39
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Perfusion
- Publication Type :
- Academic Journal
- Accession number :
- 177990814
- Full Text :
- https://doi.org/10.1177/02676591231169850