Clinical importance of red cell distribution width and red cell index in pulmonary embolism

E. Babaoglu, S.S. Ulasli

Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey. ebabaoglu@hacettepe.edu.tr

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• Respiratory Medicine

OBJECTIVE: Discrimination of high mortality risk pulmonary embolism (PE) patients at the first admission to the hospital is important for the follow-up and the clinical progress of patients. Additional biomarkers are needed for the initial assessment. The aim of this study was to investigate whether red cell distribution width (RDW) and red cell index (RCI) were associated with 30-day mortality risk and mortality rate in PE patients.

PATIENTS AND METHODS: 101 PE patients and 92 non-PE patients were included in the study. PE patients were divided into three groups according to 30-day mortality risk. The correlations of RDW and RCI with PE, 30-day mortality risk and mortality rates were determined.

RESULTS: RDW value was significantly higher in the PE group than in the non-PE group (15.0 % vs. 14.3%, respectively, p=0.016). The cut-off value of RDW to discriminate PE from the non-PE group was 14.55% (sensitivity: 45.7%; specificity: 55.5%, p=0.016). There was a significant correlation between RDW values and mortality rates (R2= 0.11, p=0.001). The cut-off value of RDW in mortality of PE was 15.05% (sensitivity: 40.6%, specificity: 31.2%, p=0.001). On the other hand, simultaneously measured RCI values were similar between PE and non-PE groups. There wasn’t any significant difference in RCI values between 30 day-mortality risk groups. No correlation was found between RCI and the mortality due to PE.

CONCLUSIONS: To the best of our knowledge, this is the first report in the literature to simultaneously investigate RDW and RCI values for their association with 30-day mortality risk and mortality rates in pulmonary embolism (PE) patients. Our findings suggest that RDW values may serve as a new early predictor, while RCI values were not predictive.

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