title: Red blood cell distribution width and haemoglobin are associated with hospital admission in patients with acute allergic reactions.
abstract: BACKGROUND
  Red blood cell distribution width (RDW) is significantly associated with a variety of human disorders. This study aimed to investigate whether RDW value at admission may predict the need of hospitalisation in patients presenting to the emergency department (ED) with acute allergic reactions.
  
  
  METHODS
  The study population consisted of adult patients (aged > 17) admitted to the ED for acute allergic reactions.
  
  
  RESULTS
  One hundred and thirty-two subjects were included, 12 of whom (9%) required hospital admission for severity of symptoms. Patients who needed hospital admission displayed significantly lower values of haemoglobin and significantly higher values of RDW-coefficient of variation (RDW-CV). In multivariate analysis, haemoglobin and RDW-CV were found to be independent predictors of hospital admission. The area under the curve (AUC), sensitivity and specificity for predicting hospital admission were 0.72, 0.88 and 0.42 for haemoglobin and 0.73, 0.88 and 0.50 for RDW-CV, respectively. The combination of these tests (both positive) was characterised by 0.76 AUC, 0.83 sensitivity, 0.67 specificity, 0.96 negative predictive value and 0.30 positive predictive.
  
  
  CONCLUSIONS
  The results of this study suggest that two common and inexpensive parameters such as haemoglobin and RDW are independent predictors of hospital admission in patients presenting to the ED with acute allergic reactions.
authors.affiliation: a Section of Clinical Biochemistry , University of Verona , Verona , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.affiliation: b Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma , Parma , Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Buonocore
authors.affiliation: b Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma , Parma , Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Picanza
authors.affiliation: c Emergency Department, Academic Hospital of Parma , Parma , Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Schirosa
authors.affiliation: c Emergency Department, Academic Hospital of Parma , Parma , Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cervellin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: Allergy; RDW; anaphylaxis; emergency medicine; haemoglobin