title: Relation between dynamic change of red cell distribution width and 30-day mortality in patients with acute pulmonary embolism.
abstract: OBJECTIVE
  Recent studies suggest that an increase in red cell distribution width (RDW) levels have a better prognostic value than a single measurement. In the current study, we investigated the predictive value of increasing RDW levels for mortality in acute pulmonary emboli (APE) patients.
  
  
  METHODS
  For the study, 199 APE patients who were hospitalized were enrolled. Patients were divided into three groups according to their admission and 24th hour RDW values. Patients for whom both RDW values normal were put in group 1 (normal); patients with admission RDW > 14.5% and decreased 24th hour RDW values were in group 2 (decreased); patients whose 24th hour RDW levels were >14.5% and increased compared to their baseline RDW measurement were in group 3 (increased). Clinical and laboratory findings and 30-day mortality of these groups were compared.
  
  
  RESULTS
  Mean patient age was 68 ± 16, and 48% of the patients were male. There were 98 patients (49%) in group 1, 59 patients (30%) in group 2, and 42 patients (21%) in group 3. Patients in group 3 were older, had lower eGFR and hemoglobin values, and had higher brain type natriuretic peptide values. Mortality rate was higher in group 3 (0%, 3.4%, 19%, respectively, P < .0001). Increase in RDW was independently related to mortality [HR: 4.9, (95%CI: 1.2-18, P = .02)].
  
  
  CONCLUSIONS
  APE patients with increasing RDW levels have higher mortality rates. Serial measurements of RDW may help us determine patients with high risk for mortality.
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yazıcı
authors.affiliation: Katip Celebi University, Atatürk Training and Research Hospital, Department of Cardiology, İzmir, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kırış
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Sadık Ceylan
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Sait
authors.initials: S
authors.lastname: Terzi
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Ahmet Okan
authors.initials: AO
authors.lastname: Uzun
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Emre
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Yeşilçimen
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004909:Erythrocyte Indices / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000097:blood* / Q000378:metabolism / Q000401:mortality*; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain
keywords: PESI score; pulmonary emboli; red cell distribution width; short-term mortality