Dynamic Increase of Red Cell Distribution Width Predicts Increased Risk of 30-Day Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Received 16 November 2020
Accepted for publication 8 February 2021
Published 24 February 2021 Volume 2021:16 Pages 393—400
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Mengpei Zhu,1 Lisong Dai,2 Lei Wan,3 Shuling Zhang,1 Hongxing Peng1
1Department of Respiratory Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2Radiology Department, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 3Department of Cardiovascular Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
Correspondence: Hongxing Peng
Department of Respiratory Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
Purpose: Studies have demonstrated that red blood cell distribution width (RDW) is closely associated with the prognosis of patients with chronic obstructive pulmonary disease (COPD). In addition, the dynamic changes in RDW appear to play an important role. Thus, we aimed to investigate the relationship between dynamic changes in RDW and 30-day all-cause readmission of patients with acute exacerbation of COPD (AECOPD).
Methods: In this retrospective cohort study, we enrolled patients with AECOPD hospitalized in the Department of Respiratory Medicine in Liyuan Hospital (Wuhan China), a tertiary, university-affiliated, public hospital. Patients with AECOPD were divided into three groups based on their RDW values after the first and fourth days of admission. The normal range for RDW is 10– 15%. Patients with normal RDW values were included in the normal group. Patients with an RDW value > 15% on the first day, which subsequently decreased by > 2% on the fourth day was included in the decreased group. The increased group was comprised of patients with an RDW value > 15% on the first day which continued to increase, or those with a normal RDW value on the first day which increased > 15% on the fourth day.
Results: A total of 239 patients (age: 72 years [range: 64– 81 years]; male: n=199 [83.3%]) were included. There were 108, 72, and 59 patients in the RDW normal, decreased, and increased groups, respectively; the 30-day all-cause readmission rate was 9.3%, 9.7%, 27.1%, respectively; (p=0.003), being noticeably higher in the RDW increased group. Dynamic increase of RDW (OR:3.45, 95% CI: 1.39– 8.58, p= 0.008) was independently correlated with 30-day all-cause readmission of patients with AECOPD.
Conclusion: The dynamic increase of RDW is an independent prognostic factor of 30-day all-cause readmission of patients with AECOPD.
Keywords: RDW, chronic obstructive pulmonary disease, hospitalization, readmission, prognosis
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