Department of Internal Medicine "B", Ramabam Health Care Campus, Haifa, Israel.
Department of Internal Medicine "B", Ramabam Health Care Campus, Haifa, Israel.
Respir Med. 2018 Mar;136:1-7. doi: 10.1016/j.rmed.2018.01.011. Epub 2018 Jan 31.
Acute exacerbation of COPD (AECOPD) is one of the leading causes for hospitalization and readmission in developed countries. No laboratory indices were consistently found to be associated with readmission risk. Recent evidence attests that red blood cell distribution width (RDW), conveys important information for short and long term prognosis in a variety of medical conditions. Prognostic usefulness of RDW in patients with AECOPD has not been investigated.
To evaluate the usefulness of RDW in predicting early adverse outcomes in patients hospitalized due to AECOPD.
Patients hospitalized for AECOPD between 2011 and 2013 were revised. Clinical and laboratory parameters were noted. Participants were followed to determine the incidence of readmission due to AECOPD, readmission from any cause and composite end point of readmission or death during 60 days after discharge.
539 patients were included in the study. The 60-day overall readmission rate was 26.35%, of that, 41.55% were due to AECOPD. The Presence of heart failure, pH below 7.35 at discharge and abnormal RDW were associated with the composite endpoint. The negative predictive value of normal RDW was 80.12%.
Increased RDW is an independent negative prognostic factor associated with adverse outcomes after hospitalization due to AECOPD.
COPD 急性加重（AECOPD）是发达国家住院和再入院的主要原因之一。目前尚未发现与再入院风险相关的实验室指标。最近的证据表明，红细胞分布宽度（RDW）在各种疾病的短期和长期预后中传递了重要信息。RDW 在 AECOPD 患者中的预后价值尚未得到研究。
评估 RDW 在预测因 AECOPD 住院患者早期不良结局中的作用。
对 2011 年至 2013 年期间因 AECOPD 住院的患者进行修订。记录临床和实验室参数。随访患者以确定因 AECOPD 再入院、因任何原因再入院以及出院后 60 天内再入院或死亡的复合终点发生率。
本研究共纳入 539 例患者。60 天总再入院率为 26.35%，其中 41.55%是由于 AECOPD。出院时存在心力衰竭、pH 值低于 7.35 和异常 RDW 与复合终点相关。正常 RDW 的阴性预测值为 80.12%。
RDW 升高是与 AECOPD 住院后不良结局相关的独立负预后因素。
