Investigating the Utility of Red Blood Cell Distribution Width as a Prognostic Indicator for Deterioration of Patients with Chronic Obstructive Pulmonary Disease Within One Year

Qianfeng Liu,* Kangbi Wu, Xiaofang Lin, Kali Xiang,* Jing Wang* Department of Pulmonary and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kali Xiang; Jing Wang, Department of Pulmonary and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, Hubei, 445000, People’s Republic of China, Email xkl18963926688@163.com; 366413620@qq.comBackGround: Considerable studies have demonstrated a significant association between red blood cell distribution width (RDW) and clinical adverse events in cardiovascular or respiratory diseases, infections, and pulmonary embolism. However, there are limited data on prognostic predictions for patients suffering from chronic obstructive pulmonary disease (COPD).Methods: This study conducted a retrospective cohort analysis using data gathered from patients who diagnosed with COPD in the respiratory department of The Central hospital of Enshi Tujia and Miao Autonomous Prefecture between 2018 and 2021. Specifically, the RDW was recorded on their first admission. Multivariate logistic regression analysis were employed to examine the correlation between RDW and deterioration of COPD within one-year period.Results: The cohort of 1799 patients in the study comprised 74.7% male and had an average age of 68.9 ± 9.9 years. The fully adjusted model revealed that, the RDW-middle group (≤ 13.7,> 12.8; OR 1.5, 95% CI 1.0– 2.3, p=0.055) and the RDW-high group (> 13.7; OR 1.7, 95% CI 1.1– 2.6, p=0.013) had a 50% and 70% increased risk of deterioration within 1 year, respectively, in comparison with the RDW-low group (≤ 12.8). Subgroup analysis indicated that this trend was more significant in patients with hypertension (p for interaction = 0.016), and the probability of deterioration within 1 year in the RDW-high group was 3.3 times higher compared to the RDW-low group (OR 3.3, 95% CI 1.4– 7.9, p=0.008).Conclusion: A significant association was observed between the increase in RDW and the heightened risk of deterioration within a year in patients diagnosed with COPD. Most importantly, our findings suggested the importance of RDW in enhancing the risk stratification and prevention of deterioration of COPD.Keywords: red blood cell distribution width, COPD, prognosis, deterioration, risk stratification