Intermountain Heart Institute, Intermountain Medical Center, 5121 S Cottonwood St, Salt Lake City, UT, USA.
Intermountain Heart Institute, Intermountain Medical Center, 5121 S Cottonwood St, Salt Lake City, UT, USA; Cardiology Division, Department of Internal Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, USA.
Clin Chim Acta. 2018 Jul;482:166-171. doi: 10.1016/j.cca.2018.04.006. Epub 2018 Apr 6.
The red cell distribution width (RDW) predicts mortality in numerous populations. The Intermountain Risk Scores (IMRS) predict patient outcomes using laboratory measurements including RDW. Whether the RDW or IMRS predicts in-hospital outcomes is unknown.
The predictive abilities of RDW and two IMRS formulations (the complete blood count [CBC] risk score [CBC-RS] or full IMRS using CBC plus the basic metabolic profile) were studied among percutaneous coronary intervention patients at Intermountain (males: N = 6007, females: N = 2165). Primary endpoints were a composite bleeding outcome and in-hospital mortality.
IMRS predicted the composite bleeding endpoint (females: χ = 47.1, odds ratio [OR] = 1.13 per +1 score, p < 0.001; males: χ = 108.7, OR = 1.13 per +1 score, p < 0.001) more strongly than RDW (females: χ = 1.6, OR = 1.04 per +1%, p = 0.20; males: χ = 11.2, OR = 1.09 per +1%, p < 0.001). For in-hospital mortality, RDW was predictive in females (χ = 4.3, OR = 1.13 per +1%, p = 0.037) and males (χ = 4.4, OR = 1.11 per +1%, p = 0.037), but IMRS was profoundly more predictive (females: χ = 35.5, OR = 1.36 per +1 score, p < 0.001; males: χ = 72.9, OR = 1.40 per+1 score, p < 0.001). CBC-RS was more predictive than RDW but not as powerful as IMRS.
The IMRS, the CBC-RS, and RDW predict in-hospital outcomes. Risk score-directed personalization of in-hospital clinical care should be studied.
红细胞分布宽度（RDW）可预测众多人群的死亡率。 山间风险评分（IMRS）使用包括 RDW 在内的实验室测量值来预测患者的预后。RDW 或 IMRS 哪个可以预测住院期间的结局尚不清楚。
研究了山间地区经皮冠状动脉介入治疗患者的 RDW 和两种 IMRS 公式（全血细胞计数[CBC]风险评分[CBC-RS]或使用 CBC 加基本代谢谱的完整 IMRS）的预测能力（男性：N=6007，女性：N=2165）。主要终点是复合出血结局和住院死亡率。
IMRS 比 RDW 更能预测复合出血终点（女性：χ=47.1，优势比[OR]每增加 1 分则为 1.13，p<0.001；男性：χ=108.7，OR 每增加 1 分则为 1.13，p<0.001）（女性：χ=1.6，OR 每增加 1%则为 1.04，p=0.20；男性：χ=11.2，OR 每增加 1%则为 1.09，p<0.001）。对于住院死亡率，RDW 在女性（χ=4.3，OR 每增加 1%则为 1.13，p=0.037）和男性（χ=4.4，OR 每增加 1%则为 1.11，p=0.037）中具有预测性，但 IMRS 的预测性更强（女性：χ=35.5，OR 每增加 1 分则为 1.36，p<0.001；男性：χ=72.9，OR 每增加 1 分则为 1.40，p<0.001）。CBC-RS 比 RDW 更具预测性，但不如 IMRS 强大。
IMRS、CBC-RS 和 RDW 均可预测住院期间的结局。应研究基于风险评分的住院期间临床护理的个性化治疗。
