Department of Cardiac Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.
Eur J Cardiothorac Surg. 2014 Jan;45(1):108-13. doi: 10.1093/ejcts/ezt275. Epub 2013 May 27.
Red cell distribution width (RDW) has been identified as an independent risk factor with regard to prognosis in patients with cardiac disease. We sought to investigate the association of RDW in patients undergoing lung resections for non-small-cell lung cancer with respect to in-hospital morbidity, mortality and long-term survival.
Analysis of consecutive patients on a validated prospective thoracic surgery database was performed for those undergoing potentially curative resections at a single institution. Univariate and multivariate analyses were performed for postoperative invasive and non-invasive ventilation, superficial wound infections, length of hospital stay, in-hospital mortality and long-term survival.
Overall mortality was 1.9% for all cases (n = 917). The median follow-up was 6.8 years. Univariate analysis demonstrated that RDW has a significant effect on hospital length of stay (P < 0.001), in-hospital mortality rates (P < 0.001), postoperative invasive and non-invasive ventilation (P < 0.001), superficial wound infections (P = 0.06) and long-term survival (P < 0.0001). Multivariate analysis revealed that RDW is a significant factor determining postoperative invasive and non-invasive ventilation, superficial wound infections, length of hospital stay, in-hospital mortality and long-term survival. Confounding factor analysis revealed that in the absence of anaemia, RDW was still a significant factor in the above analysis.
RDW is a significant factor after risk adjustment, determining in-hospital morbidity, mortality and long-term survival in patients post-potentially curative resections for non-small-cell lung cancer. Further work is needed to elucidate the exact mechanism of RDW impact on in-hospital morbidity, mortality and long-term survival. We speculate that subtle bone marrow dysfunction may be an issue.
红细胞分布宽度（RDW）已被确定为心脏病患者预后的独立危险因素。我们旨在研究非小细胞肺癌患者肺切除术后 RDW 与住院发病率、死亡率和长期生存率的关系。
对一家机构内进行潜在根治性切除术的连续患者进行了验证性前瞻性胸外科数据库分析。对术后有创和无创通气、浅表伤口感染、住院时间、住院死亡率和长期生存率进行单因素和多因素分析。
所有病例（n=917）的总死亡率为 1.9%。中位随访时间为 6.8 年。单因素分析表明，RDW 对住院时间（P<0.001）、住院死亡率（P<0.001）、术后有创和无创通气（P<0.001）、浅表伤口感染（P=0.06）和长期生存（P<0.0001）有显著影响。多因素分析显示，RDW 是决定术后有创和无创通气、浅表伤口感染、住院时间、住院死亡率和长期生存的重要因素。混杂因素分析显示，在无贫血的情况下，RDW 仍然是上述分析的一个重要因素。
RDW 是风险调整后的一个重要因素，决定了非小细胞肺癌潜在根治性切除术后患者的住院发病率、死亡率和长期生存率。需要进一步研究以阐明 RDW 对住院发病率、死亡率和长期生存率影响的确切机制。我们推测，骨髓功能轻微障碍可能是一个问题。
