title: Red cell distribution width and coronary artery bypass surgery.
abstract: OBJECTIVE
  The red cell distribution width (RDW) has been identified as an independent risk factor with regard to prognosis in patients with coronary artery disease with or without heart failure. We sought to investigate the role of RDW in patients undergoing isolated coronary artery bypass graft surgery (CABG).
  
  
  METHODS
  Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Univariate and multivariate analysis was performed for in hospital mortality, long-term survival, length of hospital stay, length of intensive care unit stay and creatinine kinase muscle-brain (CKMB) release.
  
  
  RESULTS
  Overall mortality was 2.1% for all cases, N = 8615. Median follow up was 5.8 years. Univariate analysis demonstrated that the RDW has a significant effect on CKMB release, P = 0.001, in-hospital mortality, P < 0.0001, and long-term survival, P < 0.0001, but no significant effect on the ITU length of stay, P = 0.9, or hospital length of stay, P = 0.2. Multivariate analysis revealed that the RDW was a significant factor determining in-hospital mortality and long-term survival, but had no significant effect on CKMB release, ITU or hospital length of stay. Confounding factor analysis revealed that in the absence of anaemia, the RDW was still a significant factor determining in-hospital mortality and long-term survival.
  
  
  CONCLUSIONS
  The RDW is a significant factor determining in-hospital mortality and long-term survival in patients undergoing isolated CABG. The mechanism of association requires further study.
authors.affiliation: Department of Cardiac Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Warwick
authors.forename: Neeraj
authors.initials: N
authors.lastname: Mediratta
authors.forename: Matthew
authors.initials: M
authors.lastname: Shaw
authors.forename: James
authors.initials: J
authors.lastname: McShane
authors.forename: Mark
authors.initials: M
authors.lastname: Pullan
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.forename: Michael
authors.initials: M
authors.lastname: Poullis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000401:mortality*; D052279:Creatine Kinase, MB Form / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D052279:Creatine Kinase, MB Form
keywords: Coronary; Creatine kinase; Mortality; Red cell distribution width; Survival