BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco...BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.展开更多
Objective:Red blood cell distribution width(RDW)has been utilized as a prognostic indicator for mortality risk assessment in cardiovascular and cerebrovascular patients.Nevertheless,the prognostic significance of RDW ...Objective:Red blood cell distribution width(RDW)has been utilized as a prognostic indicator for mortality risk assessment in cardiovascular and cerebrovascular patients.Nevertheless,the prognostic significance of RDW in critically ill patients with cerebral infarction is yet to be investigated.The objective of this study is to examine the association between RDW and the risk of all-cause mortality in cerebral infarction patients admitted to the intensive care unit(ICU).Method:A retrospective cohort study was conducted using the Medical Information Mart for Intensive Care IV 2.2(MIMIC-IV)intensive care dataset for data analysis.The main results were the all-cause mortality rates at 3 and 12 months of follow-up.Cumulative curves were plotted using the Kaplan-Meier method,and Cox proportional hazards analysis was used to examine the relationship between RDW and mortality rates in critically ill cerebral infarction patients.Results:The findings indicate that RDW serves as a significant prognostic factor for mortality risk in critically ill stroke patients,specifically at the 3 and 12-month follow-up periods.The observed correlation between increasing RDW levels and higher mortality rates among cerebral infarction patients further supports the potential utility of RDW as a predictive indicator.Conclusion:RDW emerges as an independent predictor of mortality risk during the 3 and 12-month follow-up periods for critically ill patients with cerebral infarction.展开更多
BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizin...BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.展开更多
Objective: To examine the association between elevated levels of red cell distribution width (RDW) and cardiovascular risk factors (CVRF) and metabolic syndrome (MS) in HIV-patients. Methods: Cross-sectional study inc...Objective: To examine the association between elevated levels of red cell distribution width (RDW) and cardiovascular risk factors (CVRF) and metabolic syndrome (MS) in HIV-patients. Methods: Cross-sectional study including all asymptomatic HIV-outpatients under follow-up during 2007. Patients completed a questionnaire about CVRF, underwent a physical examination, and an 8-hour fasting blood analysis. Elevated RDW was defined as ≥75th percentile. Patients with and without an elevated RDW were compared. Results: 666 patients (79.3% men) were included: mean age 44.7 years, mean CD4 506/mm3 and 87.5% on antiretroviral therapy (85.3% with undetectable viral load). Mean RDW was 13.7% (range: 7.7% - 33.6%;75th percentile, 14.1%). The prevalence per quartile of MS was 15.7%, 9.3%, 18.8% and 16.6% and of patients with CVRF > 20% was 8.4%, 4.0%, 4.4%, and 6.4%, respectively (p > 0.05);23.4% of the patients had an elevated RDW (>14.1%). The top percentile of RDW was associated with AIDS (OR 1.6;95% CI, 1.0 - 2.4;p = 0.02), detectable viral load (OR 1.5;95% CI, 1.01 - 2.4;p = 0.04) and hypertension (OR 2.3;95% CI, 1.4 - 4.0;p = 0.001). Conclusions: In HIV-outpatients, higher RDW is related with detectable viral load and with AIDS. Although it was associated with hypertension, we found no relation with MS nor with higher cardiovascular risk.展开更多
BACKGROUND Clinical diagnosis of cirrhotic cardiomyopathy(CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failur...BACKGROUND Clinical diagnosis of cirrhotic cardiomyopathy(CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.AIM To explore suitable biomarkers for early CCM prediction.METHODS A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group Ⅰ, Class A without CCM(105 cases);Group Ⅱ, Class A with CCM(175 cases);Group Ⅲ, Class B with CCM(139 cases);and Group Ⅳ, Class C with CCM(86 cases). Logistic regression and receiver operating characteristic(ROC) curve analyses were performed to determine whether red blood cell distribution width(RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease(MELD) scores, and N-terminal pro-brain natriuretic peptide(NT-proBNP) were analyzed by Pearson correlation analysis.RESULTS A constant RDW increase was evident from Group Ⅰ to Group Ⅳ(12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores(r = 0.642, P < 0.001), MELD scores(r = 0.592, P < 0.001), and NT-proBNP(r = 0.715, P < 0.001). Furthermore, between Group Ⅰ and Group Ⅱ, RDW was the only significant index(odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis(area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).CONCLUSION RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.展开更多
Background:Red cell distribution width(RDW)and serum albumin concentration are associated with postoperative outcomes.However,the usefulness of the RDW/albumin ratio in burn surgery remains unclear.Therefore,we evalua...Background:Red cell distribution width(RDW)and serum albumin concentration are associated with postoperative outcomes.However,the usefulness of the RDW/albumin ratio in burn surgery remains unclear.Therefore,we evaluated the association between RDW/albumin ratio and 90-day mortality after burn surgery.Methods:Between 2013 and 2020,a retrospective review of patients in a burn intensive care unit(ICU)was performed.Receiver operating characteristic curve,multivariate Cox logistic regression,multivariate logistic regression and Kaplan-Meier analyses were conducted to evaluate the associ-ation between RDW/albumin ratio and 90-day mortality after burn surgery.Additionally,prolonged ICU stay rate(>60 days)and ICU stay were assessed.Results:Ninety-day mortality was 22.5%(210/934)in burn patients.Risk factors for 90-day mortality were RDW/albumin ratio at postoperative day 1,age,American Society of Anesthesiologists physical status,diabetes mellitus,inhalation injury,total body surface area burned,hypotensive event and red blood cell transfusion volume.The area under the curve of the RDW/albumin ratio at postoperative day 1 to predict 90-day mortality,after adjusting for age and total body surface area burned,was 0.875(cut-off value,6.8).The 90-day mortality was significantly higher in patients with RDW/albumin ratio>6.8 than in those with RDW/albumin ratio≤6.8(49.2%vs 12.3%,p<0.001).Prolonged ICU stay rate and ICU stay were significantly higher and longer in patients with RDW/albumin ratio>6.8 than in those with RDW/albumin ratio≤6.8(34.5%vs 26.5%;21[11-38]vs 18[7-32]days).Conclusion:RDW/albumin ratio>6.8 on postoperative day 1 was associated with higher 90-day mortality,higher prolonged ICU stay rate and longer ICU stay after burn surgery.展开更多
BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized...BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.METHODS This prospective study included 204 consecutive elderly patients(age 77.5[7.41]years,female 94[46%],left ventricular ejection fraction 53.00%[37.50,55.00])hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital(Larissa,Greece)from January 2019 to April 2019.Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population.Hospitalized patients with acute CVD(acute coronary syndromes,new-onset heart failure[HF],and acute pericarditis/myocarditis),primary isolated valvular heart disease,sepsis,and those with a history of blood transfusions or cancer were excluded.The evaluation of the patients within 24 h from admission included clinical examination,laboratory blood tests,and echocardiography.RESULTS The most common cardiac morbidities were hypertension and coronary artery disease,with acutely decompensated chronic heart failure(ADCHF)and atrial fibrillation(AF)also frequently being present.The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus,chronic obstructive pulmonary disease,and sleep apnea.RDW was significantly elevated 15.48(2.15);121(59.3%)of patients had RDW>14.5%which represents the upper limit of normal in our institution.Factors associated with RDW in stepwise regression analysis were ADCHF(coefficient:1.406;95%confidence interval[CI]:0.830-1.981;P<0.001),AF(1.192;0.673 to 1.711;P<0.001),and anemia(0.806;0.256 to 1.355;P=0.004).ADCHF was the most significant factor associated with RDW.RDW was on average 1.41 higher for patients with than without ADCHF,1.19 higher for patients with than without AF,and 0.81 higher for patients with than without anemia.When patients were grouped based on the presence or absence of anemia,ADCHF and AF,heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.CONCLUSION RDW was elevated in elderly hospitalized patients with chronic CVD.Factors associated with RDW were anemia and CV factors associated with elevated heart rate(ADCHF,AF),suggesting sympathetic overactivity.展开更多
Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between...Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between AF and RDW in hypertensive patients.Methods We enrolled 432 hypertensive patients,including 350 AF patients and 82 patients as controls.Patients'demographic,clinical,laboratory and echocardiographic characteristics were recorded.The AF patients were further divided into the persistent and paroxysmal AF subgroups.Electrocardiograms were monitored to identify the cardiac rhythm during blood sampling,and based on the rhythm,the paroxysmal AF group was categorized into the presence(with AF rhythm during blood sampling)and absence(with sinus rhythm during blood sampling)groups.Results The AF group had elevated RDW levels than the controls(12.7%±0.8%vs.12.4%±0.7%,P=0.002),and the persistent AF subgroup had higher RDW levels than the paroxysmal AF subgroup(12.9%±0.8%vs.12.6%±0.8%,P=0.007).Furthermore,in the paroxysmal AF group,the presence group had higher RDW levels than the absence group(13.0%±0.6%vs.12.5%±0.9%,P=0.001).There was no significant difference in RDW levels between the persistent AF subgroup and presence group of the paroxysmal AF subgroup(P=0.533)and between the absence group of the paroxysmal AF subgroup and control group(P=0.262).In multivariate regression analysis,in hypertensive patients,the presence of AF rhythm is an independent predictor for increased RDW concentration(P=0.001).Conclusions The RDW may be associated with the presence of AF rhythm,which implies the importance of maintaining the sinus rhythm in hypertensive patients.展开更多
The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation(AF)patients at higher risk.The aim of this critical review of the scientific literature is ...The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation(AF)patients at higher risk.The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width(RDW)in AF.A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations.Data abstraction was conducted on a final number of 35 articles(13 crosssectional,12 prospective and 10 retrospective studies).The results of these epidemiological investigations were all virtually concordant to emphasize that an enhanced RDW value is not only a predictive factor and a marker of AF but its measurement may also be helpful for predicting the risk of developing many adverse complications in patients with AF,such as recurrence and duration of AF,hospitalization for heart failure,bleeding,left atrial thrombosis and stasis,thromboembolic events and mortality.AF patients with RDW values exceeding the local reference range may be more aggressively investigated and managed,in order to identify and attenuate the impact of possible underlying disorders causing both anisocytosis and AF.展开更多
BACKGROUND Looking for undiscovered blood markers of liver fibrosis and steatosis still remains an issue worth exploring.There are still plenty of unresolved issues related to the actual role of hematological indices ...BACKGROUND Looking for undiscovered blood markers of liver fibrosis and steatosis still remains an issue worth exploring.There are still plenty of unresolved issues related to the actual role of hematological indices as potential markers of liver function.AIM To study red blood cell distribution width(RDW),RDW-to-platelet ratio(RPR)and RDW-to-lymphocyte ratio(RLR) in alcohol-related liver cirrhosis(ALC) and metabolic-associated fatty liver disease(MAFLD).METHODS The study group was composed of 302 people:142 patients with ALC and 92 with MAFLD;68 persons were included as controls.RDW,RPR and RLR were measured in each person.Indirect and direct parameters of liver fibrosis were also assessed [aspartate transaminase to alkaline transaminase ratio,aspartate transaminase to platelet ratio index(APRI),fibrosis-4(FIB-4),gamma-glutamyl transpeptidase to platelet ratio(GPR),procollagen I carboxyterminal propeptide,procollagen Ⅲ aminoterminal propeptide,transforming growth factor-α,plateletderived growth factor AB,laminin].MELD score in ALC patients and nonalcoholic fatty liver disease(NAFLD) fibrosis score together with BARD score were obtained in the MAFLD group.The achieved results were compared to controls.Then a correlation between assessed markers was done.Diagnostic value of each investigated parameter and its suggested cut-off in the research group RESULTS RDW,RPR and RLR values turned out to be significantly higher in ALC and MAFLD groups compared to controls(ALC:P<0.0001;NAFLD:P<0.05,P<0.0001 and P<0.0001,respectively).RPR correlated positively with MELD score(P<0.01) and indirect indices of liver fibrosis(FIB-4 and GPR;P<0.0001) in ALC patients;negative correlations were found between PDGF-AB and both:RDW and RPR(P<0.01 and P<0.0001,respectively).RPR correlated positively with NAFLD fibrosis score and APRI(P<0.0001) in the MAFLD group;a positive relationship was observed between RDW and FIB-4,too(P<0.05).AUC values and suggested cut-offs for RDW,RPR and RLR in ALC patients were:0.912(>14.2%),0.965(>0.075) and 0.914(>8.684),respectively.AUC values and suggested cut-offs for RDW,RPR and RLR in MAFLD patients were:0.606(>12.8%),0.724(>0.047) and 0.691(>6.25),respectively.CONCLUSION RDW with its derivatives appear to be valuable diagnostic markers in patients with ALC.They can also be associated with a deterioration of liver function in this group.展开更多
Lung disease is the disease of the lung itself or lung manifestations of other diseases,including COPD,PTE,CAP,etc.In recent years,the incidence rate has been increased year after year.Many of these diseases have hidd...Lung disease is the disease of the lung itself or lung manifestations of other diseases,including COPD,PTE,CAP,etc.In recent years,the incidence rate has been increased year after year.Many of these diseases have hidden onset and complicated causes.Therefore,accurate diagnosis and treatment are very important.Studies have shown that RDW is closely linked to the diagnosis and treatment of lung diseases.This article analyzes the research on RDW and lung diseases at home and abroad,and briefly summarizes the diagnosis,severity and clinical prognosis of lung diseases by RDW,hoping to provide useful clues and reliable basis for clinical workers,to provide assistance for further application research of RDW in lung diseases.展开更多
Objective:To explore correlation between red blood cell distribution width(RDW)and cervical carcinoma.Methods:50 cervical carcinoma patients and 75 healthy controls from the First Affiliated Hospital of Soochow Univer...Objective:To explore correlation between red blood cell distribution width(RDW)and cervical carcinoma.Methods:50 cervical carcinoma patients and 75 healthy controls from the First Affiliated Hospital of Soochow University from June 2020 to December 2020 were involved as the patients group and the control group respectively.Demographic data were collected from routine blood tests and biochemistry examination,the correlation of RDW with hemoglobin(Hb)and c-reactive protein(CRP)was evaluated by Spearman rank correlation,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of RDW for cervical carcinoma.Result:The levels of RDW,squamous cell carcinoma antigen(SCCA)and carcinoembryonic antigen(CEA)in patients with cervical carcinoma were higher than those in the controls.The levels of high-density lipoprotein(HDL),Albumin,Prealbumin,Hb,RBC and neuron-specific enolase(NSE)in patients were lower than those in the controls(all P<0.05).There was no statistical significance on the difference in other markers between the two groups(P>0.05).The AUC of RDW in the diagnosis of cervical carcinoma was 0.834.Based on Spearman's rank correlation coefficient analysis,RDW was positively correlated with Hb(r=0.434,P<0.05)and CRP(r=0.366,P<0.05)RDW,and was negatively correlated with hematocrit(r=-0.363,P<0.05),in cervical carcinoma group,cervical carcinoma subgroupⅠ-ⅡandⅢ-Ⅳwere higher than the control group(P<0.05).Conclusions:Elevated RDW is associated with the occurrence of cervical carcinoma,and it may have clinical value in the diagnosis of cervical carcinoma and the course of reaction.展开更多
Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been a...Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been assessed. This study was to investigate whether RDW had additional prognostic value on KAMIR score for predicting in-hospital death of STEMI patients. Methods Seven hundred and seven STEMI patients were included in this study. The predictive value was evaluated using the receiver operating characteristic(ROC). Multivariate logistic regression was used to determine risk predictors. Results Thirty four patients died while in hospital,who were older than those who survived,and had more proportion of Killip class ≥ 2 and no in-hospital PCI. Blood glucose,serum creatinine,white blood cell count,RDW and KAMIR score were significantly higher in the Death group,among whom systolic blood pressure,hemoglobin and LVEF were lower.ROC curve analysis showed RDW could predict in-hospital death,with the optimal cut-off values being 14.1%(AUC=0.707,95%CI,0.618-0.796,P<0.001). When compared with the KAMIR score alone,the addition of RDW was associated with significant improvements in predicting in-hospital(AUC:0.865 vs. 0.839,P=0.039).Conclusion RDW might provide additional information over the KAMIR score in STEMI patients.展开更多
BACKGROUND Previous studies have reported that low hematocrit levels indicate poor survival in patients with ovarian cancer and cervical cancer,the prognostic value of hematocrit for colorectal cancer(CRC)patients has...BACKGROUND Previous studies have reported that low hematocrit levels indicate poor survival in patients with ovarian cancer and cervical cancer,the prognostic value of hematocrit for colorectal cancer(CRC)patients has not been determined.The prognostic value of red blood cell distribution width(RDW)for CRC patients was controversial.AIM To investigate the impact of RDW and hematocrit on the short-term outcomes and long-term prognosis of CRC patients who underwent radical surgery.METHODS Patients who were diagnosed with CRC and underwent radical CRC resection between January 2011 and January 2020 at a single clinical center were included.The short-term outcomes,overall survival(OS)and disease-free survival(DFS)were compared among the different groups.Cox analysis was also conducted to identify independent risk factors for OS and DFS.RESULTS There were 4258 CRC patients who underwent radical surgery included in our study.A total of 1573 patients were in the lower RDW group and 2685 patients were in the higher RDW group.There were 2166 and 2092 patients in the higher hematocrit group and lower hematocrit group,respectively.Patients in the higher RDW group had more intraoperative blood loss(P<0.01)and more overall complications(P<0.01)than did those in the lower RDW group.Similarly,patients in the lower hematocrit group had more intraoperative blood loss(P=0.012),longer hospital stay(P=0.016)and overall complications(P<0.01)than did those in the higher hematocrit group.The higher RDW group had a worse OS and DFS than did the lower RDW group for tumor node metastasis(TNM)stage I(OS,P<0.05;DFS,P=0.001)and stage II(OS,P=0.004;DFS,P=0.01)than the lower RDW group;the lower hematocrit group had worse OS and DFS for TNM stage II(OS,P<0.05;DFS,P=0.001)and stage III(OS,P=0.001;DFS,P=0.001)than did the higher hematocrit group.Preoperative hematocrit was an independent risk factor for OS[P=0.017,hazard ratio(HR)=1.256,95%confidence interval(CI):1.041-1.515]and DFS(P=0.035,HR=1.194,95%CI:1.013-1.408).CONCLUSION A higher preoperative RDW and lower hematocrit were associated with more postoperative complications.However,only hematocrit was an independent risk factor for OS and DFS in CRC patients who underwent radical surgery,while RDW was not.展开更多
Background:The predictive value of red blood cell distribution width(RDW)for mortality in patients withsepsis-induced acute kidney injury(SI-AKI)remains unclear.The present study aimed to investigate the potentialasso...Background:The predictive value of red blood cell distribution width(RDW)for mortality in patients withsepsis-induced acute kidney injury(SI-AKI)remains unclear.The present study aimed to investigate the potentialassociation between RDW at admission and outcomes in patients with SI-AKI.Methods:The Medical Information Mart for Intensive Care(MIMIC)-IV(version 2.0)database,released in Juneof 2022,provides medical data of SI-AKI patients to conduct our related research.Based on propensity scorematching(PSM)method,the main risk factors associated with mortality in SI-AKI were evaluated using Coxproportional hazards regression analysis to construct a predictive nomogram.The concordance index(C-index)and decision curve analysis were used to validate the predictive ability and clinical utility of this model.Patientswith SI-AKI were classified into the high-and low-RDW groups according to the best cut-off value obtained bycalculating the maximum value of the Youden index.Results:A total of 7574 patients with SI-AKI were identified according to the filter criteria.Compared withthe low-RDW group,the high-RDW group had higher 28-day(9.49%vs.31.40%,respectively,P<0.001)and7-day(3.96%vs.13.93%,respectively,P<0.001)mortality rates.Patients in the high-RDW group were moreprone to AKI progression than those in the low-RDW group(20.80%vs.13.60%,respectively,P<0.001).Basedon matched patients,we developed a nomogram model that included age,white blood cells,RDW,combinedhypertension and presence of a malignant tumor,treatment with vasopressor,dialysis,and invasive ventilation,sequential organ failure assessment,and AKI stages.The C-index for predicting the probability of 28-day survivalwas 0.799.Decision curve analysis revealed that the model with RDW offered greater net benefit than that withoutRDW.Conclusion:The present findings demonstrated the importance of RDW,which improved the predictive ability ofthe nomogram model for the probability of survival in patients with SI-AKI.展开更多
Background and aims:Hepatitis B virus(HBV)infection is a major public health issue worldwide as it may cause serious liver diseases such as cirrhosis and hepatocellular carcinoma(HCC).Ruling out cirrhosis is important...Background and aims:Hepatitis B virus(HBV)infection is a major public health issue worldwide as it may cause serious liver diseases such as cirrhosis and hepatocellular carcinoma(HCC).Ruling out cirrhosis is important when treating chronic hepatitis B(CHB).The aim of this study was to compare the performance of the aspartate aminotransferase-to-platelet ratio index(APRI),fibrosis score based on four factors(FIB-4),and red cell volume distribution width-to-platelet ratio(RPR)in diagnosing liver fibrosis stages and to identify new cut-off values to rule out cirrhosis.Methods:Between 2005 and 2020,2182 eligible individuals who underwent liver biopsy were randomly assigned to derivation and validation cohorts in a 6:4 ratio.A grid search was applied to identify optimal cut-off values with a sensitivity of>90% and a negative predictive value(NPV)of at least 95%.Results:Overall,1309 individuals(175 patients with cirrhosis)were included in the derivation dataset,and 873(117 patients with cirrhosis)were included in the validation cohort.The area under the receiver operating characteristic curve of RPR for diagnosing cirrhosis was 0.821,which was comparable to that of APRI(0.818,P=0.7905)and FIB-4(0.803,P=0.2395).When applying an RPR of 0.06,cirrhosis was correctly identified with a sensitivity of 93.1% and an NPV of 97.1%,while it misclassified 12 of 175(6.9%)patients in the derivation cohort.In the validation cohort,RPR had a sensitivity and NPV of 97.4% and 99.0%,respectively,and only misclassified 3 of 117(2.6%)patients.Subgroup analysis indicated that the new RPR cut-off value performed more consistently than that of APRI and FIB-4 in all subgroups.Conclusion:A recently established cut-off value for RPR(≤0.06)was validated and was more effective than APRI and FIB-4 in excluding patients with cirrhosis due to a higher sensitivity and NPV and a lower misclassification rate.This simple and dependable test could have significant clinical implications in identifying patients who require monitoring for portal hypertension-associated complications and screening for HCC,particularly in middle and primary healthcare settings.展开更多
[Objectives]To observe the effects of daphnetin on mastitis induced by Staphylococcus aureus in mice.[Methods]18 postpartum ICR female mice were used to establish mastitis animal model,and were randomly divided into t...[Objectives]To observe the effects of daphnetin on mastitis induced by Staphylococcus aureus in mice.[Methods]18 postpartum ICR female mice were used to establish mastitis animal model,and were randomly divided into three groups(A,B,and C)with 6 mice in each group.Group A:blank control group;group B:S.Aureus model group;group C:S.Aureus model+daphnetin group.The experimental groups were injected 1 mL of 1.0×104 CFU/100μL of S.aureus of along the nipple catheter.The suspension was placed in the 3 rd and 4 th pairs of mammary glands,and the control group was injected with the same dose of normal saline.On the second day after infection,the rats in group A,B and C were given drugs by gavage,while the rats in group A and B were given normal saline and the rats in group C were given daphnetin once a day for 6 consecutive days.Blood samples were collected from living eyeballs,and blood cells were analyzed by automatic flow cytometer after anticoagulation.[Results]The NLR and Systemie Immune Inflammati-on Index(SII)in the blood of mastitis mice induced by S.aureus were significantly higher than those in the control group(P<0.01),suggesting that neutrophil to lymphocyte ratio(NLR)and SII can be used as diagnostic indicators of mastitis,and the levels of NLR and SII decreased significantly after daphnetin intervention.[Conclusions]NLR and SII showed high levels in mastitis mice,which are valuable for the diagnosis of mastitis and the evaluation of its prognosis.After the intervention of daphnetin,both of them decreased significantly,indicating that daphnetin has a good prognosis trend in mastitis mice induced by S.aureus.展开更多
BACKGROUND Indices such as the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),mean platelet volume(MPV),platelet distribution width(PDW),and red cell distribution width(RDW)are considered new ma...BACKGROUND Indices such as the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),mean platelet volume(MPV),platelet distribution width(PDW),and red cell distribution width(RDW)are considered new markers of the systemic inflammatory response(SIR),and have been widely implemented for the diagnosis of patients with inflammatory diseases.These new indicators have also been widely investigated in preeclampsia(PE)but less analyzed in hemolysis,elevated liver enzymes,and low platelet(HELLP)syndrome.AIM To compare SIR markers among HELLP patients,PE only patients,and healthy gravidae.METHODS This retrospective case-control study enrolled 630 cases,including 210 patients with HELLP syndrome(HELLP group),210 patients with only PE(PE group)and 210 healthy gravidae(control group).The three groups were matched by age,parity,status of assisted reproduction,and multiple pregnancies.Birthweight,gestational age at complete blood count collection,gestational age at delivery,mode of delivery,etc.were recorded.The main indices as NLR,PLR,MPV,PDW,and RDW among the groups were compared,as well as some secondary outcomes including neutrophil,platelets,and hemoglobin.RESULTS The NLR(6.4 vs 4.3 vs 3.5),MPV(11.9 vs 11.2 vs 10.7),PDW(16.4 vs 13.3 vs 14.2),leukocyte(12.4×10^(9)/L vs 9.7×10^(9)/L vs 8.7×10^(9)/L)and neutrophil count(9.9×10^(9)/L vs 7.3×10^(9)/L vs 6.1×10^(9)/L)were highest in the HELLP group,lower in the PE group,and lowest in the control group.Both the overall comparisons between the three groups(all bP<0.01)and pairwise comparisons between every two groups elicited statistically significant differences(all dP<0.01,except control vs PE:cP<0.05 in PDW).The average lymphocyte counts were 1.4(1.1,2.0)×10^(9)/L in the HELLP group,1.6(1.3,2.0)×10^(9)/L in the PE group and 1.7(1.4,2.0)×10^(9)/L in the control group.The overall comparison of lymphocyte count within the three groups had statistically significant differences(P=0.000).The pairwise comparisons between every two groups demonstrated that the HELLP group had a lower lymphocyte count than both the PE(P=0.019)and control groups(P=0.000),but the difference between the PE and control groups was not statistically significant(P=0.432).The overall comparisons on platelet counts and the PLR among these three groups also showed statistically significant differences(both P=0.000),from low to high being those in the HELLP group(43.4×10^(9)/L,64.0),control group(180.5×10^(9)/L,103.6)and PE group(181.5×10^(9)/L,112.8).Pairwise comparisons of neither index displayed statistically significant differences between the PE and control groups(both P>0.05),while the differences in the two indices between the HELLP group and the two other groups were still statistically significant(all P=0.000).RDW values were highest in the HELLP group(14.5%[13.6,15.3]),lower in the control group(14.1%[13.5,14.8])and lowest in the PE group(13.9%[13.4,14.9]).The difference between the PE and control group did not show statistical significance(P=1.000),while RDW values in the HELLP group were higher than those in the other two groups(cP<0.05 vs control,dP<0.01 vs PE).CONCLUSION SIR markers such as NLR,RDW,MPV,and PDW were increased and PLR was decreased in HELLP.These SIR markers may become new indicators in the evaluation of HELLP syndrome.展开更多
文摘BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.
基金Project of Science and Technology Plan of Tianjin City(Grant number 20ZYJDSY00020)。
文摘Objective:Red blood cell distribution width(RDW)has been utilized as a prognostic indicator for mortality risk assessment in cardiovascular and cerebrovascular patients.Nevertheless,the prognostic significance of RDW in critically ill patients with cerebral infarction is yet to be investigated.The objective of this study is to examine the association between RDW and the risk of all-cause mortality in cerebral infarction patients admitted to the intensive care unit(ICU).Method:A retrospective cohort study was conducted using the Medical Information Mart for Intensive Care IV 2.2(MIMIC-IV)intensive care dataset for data analysis.The main results were the all-cause mortality rates at 3 and 12 months of follow-up.Cumulative curves were plotted using the Kaplan-Meier method,and Cox proportional hazards analysis was used to examine the relationship between RDW and mortality rates in critically ill cerebral infarction patients.Results:The findings indicate that RDW serves as a significant prognostic factor for mortality risk in critically ill stroke patients,specifically at the 3 and 12-month follow-up periods.The observed correlation between increasing RDW levels and higher mortality rates among cerebral infarction patients further supports the potential utility of RDW as a predictive indicator.Conclusion:RDW emerges as an independent predictor of mortality risk during the 3 and 12-month follow-up periods for critically ill patients with cerebral infarction.
基金the Science and Technology Program of Guiyang Baiyun District Science and Technology Bureau.No.[2017]50Science and Technology Program of Guiyang Municipal Bureau of Science and Technology,No.[2018]1-72Science and Technology Fund Project of Guizhou Provincial Health Commission,No.gzwkj2021-127.
文摘BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.
文摘Objective: To examine the association between elevated levels of red cell distribution width (RDW) and cardiovascular risk factors (CVRF) and metabolic syndrome (MS) in HIV-patients. Methods: Cross-sectional study including all asymptomatic HIV-outpatients under follow-up during 2007. Patients completed a questionnaire about CVRF, underwent a physical examination, and an 8-hour fasting blood analysis. Elevated RDW was defined as ≥75th percentile. Patients with and without an elevated RDW were compared. Results: 666 patients (79.3% men) were included: mean age 44.7 years, mean CD4 506/mm3 and 87.5% on antiretroviral therapy (85.3% with undetectable viral load). Mean RDW was 13.7% (range: 7.7% - 33.6%;75th percentile, 14.1%). The prevalence per quartile of MS was 15.7%, 9.3%, 18.8% and 16.6% and of patients with CVRF > 20% was 8.4%, 4.0%, 4.4%, and 6.4%, respectively (p > 0.05);23.4% of the patients had an elevated RDW (>14.1%). The top percentile of RDW was associated with AIDS (OR 1.6;95% CI, 1.0 - 2.4;p = 0.02), detectable viral load (OR 1.5;95% CI, 1.01 - 2.4;p = 0.04) and hypertension (OR 2.3;95% CI, 1.4 - 4.0;p = 0.001). Conclusions: In HIV-outpatients, higher RDW is related with detectable viral load and with AIDS. Although it was associated with hypertension, we found no relation with MS nor with higher cardiovascular risk.
基金Supported by the Fujian Provincial Education and Scientific Research Project,No.JAT200121Fujian Provincial Health Technology Project,No.2021QNA021.
文摘BACKGROUND Clinical diagnosis of cirrhotic cardiomyopathy(CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.AIM To explore suitable biomarkers for early CCM prediction.METHODS A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group Ⅰ, Class A without CCM(105 cases);Group Ⅱ, Class A with CCM(175 cases);Group Ⅲ, Class B with CCM(139 cases);and Group Ⅳ, Class C with CCM(86 cases). Logistic regression and receiver operating characteristic(ROC) curve analyses were performed to determine whether red blood cell distribution width(RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease(MELD) scores, and N-terminal pro-brain natriuretic peptide(NT-proBNP) were analyzed by Pearson correlation analysis.RESULTS A constant RDW increase was evident from Group Ⅰ to Group Ⅳ(12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores(r = 0.642, P < 0.001), MELD scores(r = 0.592, P < 0.001), and NT-proBNP(r = 0.715, P < 0.001). Furthermore, between Group Ⅰ and Group Ⅱ, RDW was the only significant index(odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis(area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).CONCLUSION RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.
文摘Background:Red cell distribution width(RDW)and serum albumin concentration are associated with postoperative outcomes.However,the usefulness of the RDW/albumin ratio in burn surgery remains unclear.Therefore,we evaluated the association between RDW/albumin ratio and 90-day mortality after burn surgery.Methods:Between 2013 and 2020,a retrospective review of patients in a burn intensive care unit(ICU)was performed.Receiver operating characteristic curve,multivariate Cox logistic regression,multivariate logistic regression and Kaplan-Meier analyses were conducted to evaluate the associ-ation between RDW/albumin ratio and 90-day mortality after burn surgery.Additionally,prolonged ICU stay rate(>60 days)and ICU stay were assessed.Results:Ninety-day mortality was 22.5%(210/934)in burn patients.Risk factors for 90-day mortality were RDW/albumin ratio at postoperative day 1,age,American Society of Anesthesiologists physical status,diabetes mellitus,inhalation injury,total body surface area burned,hypotensive event and red blood cell transfusion volume.The area under the curve of the RDW/albumin ratio at postoperative day 1 to predict 90-day mortality,after adjusting for age and total body surface area burned,was 0.875(cut-off value,6.8).The 90-day mortality was significantly higher in patients with RDW/albumin ratio>6.8 than in those with RDW/albumin ratio≤6.8(49.2%vs 12.3%,p<0.001).Prolonged ICU stay rate and ICU stay were significantly higher and longer in patients with RDW/albumin ratio>6.8 than in those with RDW/albumin ratio≤6.8(34.5%vs 26.5%;21[11-38]vs 18[7-32]days).Conclusion:RDW/albumin ratio>6.8 on postoperative day 1 was associated with higher 90-day mortality,higher prolonged ICU stay rate and longer ICU stay after burn surgery.
文摘BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.METHODS This prospective study included 204 consecutive elderly patients(age 77.5[7.41]years,female 94[46%],left ventricular ejection fraction 53.00%[37.50,55.00])hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital(Larissa,Greece)from January 2019 to April 2019.Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population.Hospitalized patients with acute CVD(acute coronary syndromes,new-onset heart failure[HF],and acute pericarditis/myocarditis),primary isolated valvular heart disease,sepsis,and those with a history of blood transfusions or cancer were excluded.The evaluation of the patients within 24 h from admission included clinical examination,laboratory blood tests,and echocardiography.RESULTS The most common cardiac morbidities were hypertension and coronary artery disease,with acutely decompensated chronic heart failure(ADCHF)and atrial fibrillation(AF)also frequently being present.The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus,chronic obstructive pulmonary disease,and sleep apnea.RDW was significantly elevated 15.48(2.15);121(59.3%)of patients had RDW>14.5%which represents the upper limit of normal in our institution.Factors associated with RDW in stepwise regression analysis were ADCHF(coefficient:1.406;95%confidence interval[CI]:0.830-1.981;P<0.001),AF(1.192;0.673 to 1.711;P<0.001),and anemia(0.806;0.256 to 1.355;P=0.004).ADCHF was the most significant factor associated with RDW.RDW was on average 1.41 higher for patients with than without ADCHF,1.19 higher for patients with than without AF,and 0.81 higher for patients with than without anemia.When patients were grouped based on the presence or absence of anemia,ADCHF and AF,heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.CONCLUSION RDW was elevated in elderly hospitalized patients with chronic CVD.Factors associated with RDW were anemia and CV factors associated with elevated heart rate(ADCHF,AF),suggesting sympathetic overactivity.
基金supported by the National Natural Scientific Foundation of China(No.81600275)。
文摘Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between AF and RDW in hypertensive patients.Methods We enrolled 432 hypertensive patients,including 350 AF patients and 82 patients as controls.Patients'demographic,clinical,laboratory and echocardiographic characteristics were recorded.The AF patients were further divided into the persistent and paroxysmal AF subgroups.Electrocardiograms were monitored to identify the cardiac rhythm during blood sampling,and based on the rhythm,the paroxysmal AF group was categorized into the presence(with AF rhythm during blood sampling)and absence(with sinus rhythm during blood sampling)groups.Results The AF group had elevated RDW levels than the controls(12.7%±0.8%vs.12.4%±0.7%,P=0.002),and the persistent AF subgroup had higher RDW levels than the paroxysmal AF subgroup(12.9%±0.8%vs.12.6%±0.8%,P=0.007).Furthermore,in the paroxysmal AF group,the presence group had higher RDW levels than the absence group(13.0%±0.6%vs.12.5%±0.9%,P=0.001).There was no significant difference in RDW levels between the persistent AF subgroup and presence group of the paroxysmal AF subgroup(P=0.533)and between the absence group of the paroxysmal AF subgroup and control group(P=0.262).In multivariate regression analysis,in hypertensive patients,the presence of AF rhythm is an independent predictor for increased RDW concentration(P=0.001).Conclusions The RDW may be associated with the presence of AF rhythm,which implies the importance of maintaining the sinus rhythm in hypertensive patients.
文摘The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation(AF)patients at higher risk.The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width(RDW)in AF.A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations.Data abstraction was conducted on a final number of 35 articles(13 crosssectional,12 prospective and 10 retrospective studies).The results of these epidemiological investigations were all virtually concordant to emphasize that an enhanced RDW value is not only a predictive factor and a marker of AF but its measurement may also be helpful for predicting the risk of developing many adverse complications in patients with AF,such as recurrence and duration of AF,hospitalization for heart failure,bleeding,left atrial thrombosis and stasis,thromboembolic events and mortality.AF patients with RDW values exceeding the local reference range may be more aggressively investigated and managed,in order to identify and attenuate the impact of possible underlying disorders causing both anisocytosis and AF.
基金The survey was accepted by the local ethics committee of the Medical University of Lublin(No.KE-0254/86/2016).
文摘BACKGROUND Looking for undiscovered blood markers of liver fibrosis and steatosis still remains an issue worth exploring.There are still plenty of unresolved issues related to the actual role of hematological indices as potential markers of liver function.AIM To study red blood cell distribution width(RDW),RDW-to-platelet ratio(RPR)and RDW-to-lymphocyte ratio(RLR) in alcohol-related liver cirrhosis(ALC) and metabolic-associated fatty liver disease(MAFLD).METHODS The study group was composed of 302 people:142 patients with ALC and 92 with MAFLD;68 persons were included as controls.RDW,RPR and RLR were measured in each person.Indirect and direct parameters of liver fibrosis were also assessed [aspartate transaminase to alkaline transaminase ratio,aspartate transaminase to platelet ratio index(APRI),fibrosis-4(FIB-4),gamma-glutamyl transpeptidase to platelet ratio(GPR),procollagen I carboxyterminal propeptide,procollagen Ⅲ aminoterminal propeptide,transforming growth factor-α,plateletderived growth factor AB,laminin].MELD score in ALC patients and nonalcoholic fatty liver disease(NAFLD) fibrosis score together with BARD score were obtained in the MAFLD group.The achieved results were compared to controls.Then a correlation between assessed markers was done.Diagnostic value of each investigated parameter and its suggested cut-off in the research group RESULTS RDW,RPR and RLR values turned out to be significantly higher in ALC and MAFLD groups compared to controls(ALC:P<0.0001;NAFLD:P<0.05,P<0.0001 and P<0.0001,respectively).RPR correlated positively with MELD score(P<0.01) and indirect indices of liver fibrosis(FIB-4 and GPR;P<0.0001) in ALC patients;negative correlations were found between PDGF-AB and both:RDW and RPR(P<0.01 and P<0.0001,respectively).RPR correlated positively with NAFLD fibrosis score and APRI(P<0.0001) in the MAFLD group;a positive relationship was observed between RDW and FIB-4,too(P<0.05).AUC values and suggested cut-offs for RDW,RPR and RLR in ALC patients were:0.912(>14.2%),0.965(>0.075) and 0.914(>8.684),respectively.AUC values and suggested cut-offs for RDW,RPR and RLR in MAFLD patients were:0.606(>12.8%),0.724(>0.047) and 0.691(>6.25),respectively.CONCLUSION RDW with its derivatives appear to be valuable diagnostic markers in patients with ALC.They can also be associated with a deterioration of liver function in this group.
基金Fund project:Health and family planning commission of Shanxi province(No.2018GW03)。
文摘Lung disease is the disease of the lung itself or lung manifestations of other diseases,including COPD,PTE,CAP,etc.In recent years,the incidence rate has been increased year after year.Many of these diseases have hidden onset and complicated causes.Therefore,accurate diagnosis and treatment are very important.Studies have shown that RDW is closely linked to the diagnosis and treatment of lung diseases.This article analyzes the research on RDW and lung diseases at home and abroad,and briefly summarizes the diagnosis,severity and clinical prognosis of lung diseases by RDW,hoping to provide useful clues and reliable basis for clinical workers,to provide assistance for further application research of RDW in lung diseases.
基金National Natural Science Foundation of China(No.81873431)。
文摘Objective:To explore correlation between red blood cell distribution width(RDW)and cervical carcinoma.Methods:50 cervical carcinoma patients and 75 healthy controls from the First Affiliated Hospital of Soochow University from June 2020 to December 2020 were involved as the patients group and the control group respectively.Demographic data were collected from routine blood tests and biochemistry examination,the correlation of RDW with hemoglobin(Hb)and c-reactive protein(CRP)was evaluated by Spearman rank correlation,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of RDW for cervical carcinoma.Result:The levels of RDW,squamous cell carcinoma antigen(SCCA)and carcinoembryonic antigen(CEA)in patients with cervical carcinoma were higher than those in the controls.The levels of high-density lipoprotein(HDL),Albumin,Prealbumin,Hb,RBC and neuron-specific enolase(NSE)in patients were lower than those in the controls(all P<0.05).There was no statistical significance on the difference in other markers between the two groups(P>0.05).The AUC of RDW in the diagnosis of cervical carcinoma was 0.834.Based on Spearman's rank correlation coefficient analysis,RDW was positively correlated with Hb(r=0.434,P<0.05)and CRP(r=0.366,P<0.05)RDW,and was negatively correlated with hematocrit(r=-0.363,P<0.05),in cervical carcinoma group,cervical carcinoma subgroupⅠ-ⅡandⅢ-Ⅳwere higher than the control group(P<0.05).Conclusions:Elevated RDW is associated with the occurrence of cervical carcinoma,and it may have clinical value in the diagnosis of cervical carcinoma and the course of reaction.
基金supported by Guangdong Provincial Department of Science and Technology(No:2015A020210061)
文摘Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been assessed. This study was to investigate whether RDW had additional prognostic value on KAMIR score for predicting in-hospital death of STEMI patients. Methods Seven hundred and seven STEMI patients were included in this study. The predictive value was evaluated using the receiver operating characteristic(ROC). Multivariate logistic regression was used to determine risk predictors. Results Thirty four patients died while in hospital,who were older than those who survived,and had more proportion of Killip class ≥ 2 and no in-hospital PCI. Blood glucose,serum creatinine,white blood cell count,RDW and KAMIR score were significantly higher in the Death group,among whom systolic blood pressure,hemoglobin and LVEF were lower.ROC curve analysis showed RDW could predict in-hospital death,with the optimal cut-off values being 14.1%(AUC=0.707,95%CI,0.618-0.796,P<0.001). When compared with the KAMIR score alone,the addition of RDW was associated with significant improvements in predicting in-hospital(AUC:0.865 vs. 0.839,P=0.039).Conclusion RDW might provide additional information over the KAMIR score in STEMI patients.
基金The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University(2022-K205),this study was conducted in accordance with the World Medical Association Declaration of Helsinki as well。
文摘BACKGROUND Previous studies have reported that low hematocrit levels indicate poor survival in patients with ovarian cancer and cervical cancer,the prognostic value of hematocrit for colorectal cancer(CRC)patients has not been determined.The prognostic value of red blood cell distribution width(RDW)for CRC patients was controversial.AIM To investigate the impact of RDW and hematocrit on the short-term outcomes and long-term prognosis of CRC patients who underwent radical surgery.METHODS Patients who were diagnosed with CRC and underwent radical CRC resection between January 2011 and January 2020 at a single clinical center were included.The short-term outcomes,overall survival(OS)and disease-free survival(DFS)were compared among the different groups.Cox analysis was also conducted to identify independent risk factors for OS and DFS.RESULTS There were 4258 CRC patients who underwent radical surgery included in our study.A total of 1573 patients were in the lower RDW group and 2685 patients were in the higher RDW group.There were 2166 and 2092 patients in the higher hematocrit group and lower hematocrit group,respectively.Patients in the higher RDW group had more intraoperative blood loss(P<0.01)and more overall complications(P<0.01)than did those in the lower RDW group.Similarly,patients in the lower hematocrit group had more intraoperative blood loss(P=0.012),longer hospital stay(P=0.016)and overall complications(P<0.01)than did those in the higher hematocrit group.The higher RDW group had a worse OS and DFS than did the lower RDW group for tumor node metastasis(TNM)stage I(OS,P<0.05;DFS,P=0.001)and stage II(OS,P=0.004;DFS,P=0.01)than the lower RDW group;the lower hematocrit group had worse OS and DFS for TNM stage II(OS,P<0.05;DFS,P=0.001)and stage III(OS,P=0.001;DFS,P=0.001)than did the higher hematocrit group.Preoperative hematocrit was an independent risk factor for OS[P=0.017,hazard ratio(HR)=1.256,95%confidence interval(CI):1.041-1.515]and DFS(P=0.035,HR=1.194,95%CI:1.013-1.408).CONCLUSION A higher preoperative RDW and lower hematocrit were associated with more postoperative complications.However,only hematocrit was an independent risk factor for OS and DFS in CRC patients who underwent radical surgery,while RDW was not.
基金This work was supported by the National Natural Science Foundation of China(grant numbers:81901960 and 81902006)the Foundation of Shanghai Hospital Development Center(grant number:SHDC2020CR4100).
文摘Background:The predictive value of red blood cell distribution width(RDW)for mortality in patients withsepsis-induced acute kidney injury(SI-AKI)remains unclear.The present study aimed to investigate the potentialassociation between RDW at admission and outcomes in patients with SI-AKI.Methods:The Medical Information Mart for Intensive Care(MIMIC)-IV(version 2.0)database,released in Juneof 2022,provides medical data of SI-AKI patients to conduct our related research.Based on propensity scorematching(PSM)method,the main risk factors associated with mortality in SI-AKI were evaluated using Coxproportional hazards regression analysis to construct a predictive nomogram.The concordance index(C-index)and decision curve analysis were used to validate the predictive ability and clinical utility of this model.Patientswith SI-AKI were classified into the high-and low-RDW groups according to the best cut-off value obtained bycalculating the maximum value of the Youden index.Results:A total of 7574 patients with SI-AKI were identified according to the filter criteria.Compared withthe low-RDW group,the high-RDW group had higher 28-day(9.49%vs.31.40%,respectively,P<0.001)and7-day(3.96%vs.13.93%,respectively,P<0.001)mortality rates.Patients in the high-RDW group were moreprone to AKI progression than those in the low-RDW group(20.80%vs.13.60%,respectively,P<0.001).Basedon matched patients,we developed a nomogram model that included age,white blood cells,RDW,combinedhypertension and presence of a malignant tumor,treatment with vasopressor,dialysis,and invasive ventilation,sequential organ failure assessment,and AKI stages.The C-index for predicting the probability of 28-day survivalwas 0.799.Decision curve analysis revealed that the model with RDW offered greater net benefit than that withoutRDW.Conclusion:The present findings demonstrated the importance of RDW,which improved the predictive ability ofthe nomogram model for the probability of survival in patients with SI-AKI.
基金supported by grants from the Natural Science Foundation of Guangdong Province for Distinguished Young Scholar(2022B1515020024)the National Natural Science Foundation of China(82070574)the Natural Science Foundation Team Project of Guangdong Province(2018B030312009).
文摘Background and aims:Hepatitis B virus(HBV)infection is a major public health issue worldwide as it may cause serious liver diseases such as cirrhosis and hepatocellular carcinoma(HCC).Ruling out cirrhosis is important when treating chronic hepatitis B(CHB).The aim of this study was to compare the performance of the aspartate aminotransferase-to-platelet ratio index(APRI),fibrosis score based on four factors(FIB-4),and red cell volume distribution width-to-platelet ratio(RPR)in diagnosing liver fibrosis stages and to identify new cut-off values to rule out cirrhosis.Methods:Between 2005 and 2020,2182 eligible individuals who underwent liver biopsy were randomly assigned to derivation and validation cohorts in a 6:4 ratio.A grid search was applied to identify optimal cut-off values with a sensitivity of>90% and a negative predictive value(NPV)of at least 95%.Results:Overall,1309 individuals(175 patients with cirrhosis)were included in the derivation dataset,and 873(117 patients with cirrhosis)were included in the validation cohort.The area under the receiver operating characteristic curve of RPR for diagnosing cirrhosis was 0.821,which was comparable to that of APRI(0.818,P=0.7905)and FIB-4(0.803,P=0.2395).When applying an RPR of 0.06,cirrhosis was correctly identified with a sensitivity of 93.1% and an NPV of 97.1%,while it misclassified 12 of 175(6.9%)patients in the derivation cohort.In the validation cohort,RPR had a sensitivity and NPV of 97.4% and 99.0%,respectively,and only misclassified 3 of 117(2.6%)patients.Subgroup analysis indicated that the new RPR cut-off value performed more consistently than that of APRI and FIB-4 in all subgroups.Conclusion:A recently established cut-off value for RPR(≤0.06)was validated and was more effective than APRI and FIB-4 in excluding patients with cirrhosis due to a higher sensitivity and NPV and a lower misclassification rate.This simple and dependable test could have significant clinical implications in identifying patients who require monitoring for portal hypertension-associated complications and screening for HCC,particularly in middle and primary healthcare settings.
基金Supported by Project of Innovation and Entrepreneurship Training Program for College Students in Guangxi Zhuang Autonomous Region in 2022(S202210599060)Basic Ability Improvement Project for Young and Middle-aged Teachers in Guangxi Zhuang Autonomous Region in 2020(2020KY13027)Project of Scientific Research and Technological Development Plan of Baise City in 2020(Encyclopedia[2020]No.47).
文摘[Objectives]To observe the effects of daphnetin on mastitis induced by Staphylococcus aureus in mice.[Methods]18 postpartum ICR female mice were used to establish mastitis animal model,and were randomly divided into three groups(A,B,and C)with 6 mice in each group.Group A:blank control group;group B:S.Aureus model group;group C:S.Aureus model+daphnetin group.The experimental groups were injected 1 mL of 1.0×104 CFU/100μL of S.aureus of along the nipple catheter.The suspension was placed in the 3 rd and 4 th pairs of mammary glands,and the control group was injected with the same dose of normal saline.On the second day after infection,the rats in group A,B and C were given drugs by gavage,while the rats in group A and B were given normal saline and the rats in group C were given daphnetin once a day for 6 consecutive days.Blood samples were collected from living eyeballs,and blood cells were analyzed by automatic flow cytometer after anticoagulation.[Results]The NLR and Systemie Immune Inflammati-on Index(SII)in the blood of mastitis mice induced by S.aureus were significantly higher than those in the control group(P<0.01),suggesting that neutrophil to lymphocyte ratio(NLR)and SII can be used as diagnostic indicators of mastitis,and the levels of NLR and SII decreased significantly after daphnetin intervention.[Conclusions]NLR and SII showed high levels in mastitis mice,which are valuable for the diagnosis of mastitis and the evaluation of its prognosis.After the intervention of daphnetin,both of them decreased significantly,indicating that daphnetin has a good prognosis trend in mastitis mice induced by S.aureus.
基金Supported by the People’s Wellbeing Project of Suzhou City,No.SS201710the Clinical Expert Team Introduction Project of Suzhou City,No.SZYJTD201709and the Research Project on Maternal and Child Health of Jiangsu Province,No.F202045.
文摘BACKGROUND Indices such as the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),mean platelet volume(MPV),platelet distribution width(PDW),and red cell distribution width(RDW)are considered new markers of the systemic inflammatory response(SIR),and have been widely implemented for the diagnosis of patients with inflammatory diseases.These new indicators have also been widely investigated in preeclampsia(PE)but less analyzed in hemolysis,elevated liver enzymes,and low platelet(HELLP)syndrome.AIM To compare SIR markers among HELLP patients,PE only patients,and healthy gravidae.METHODS This retrospective case-control study enrolled 630 cases,including 210 patients with HELLP syndrome(HELLP group),210 patients with only PE(PE group)and 210 healthy gravidae(control group).The three groups were matched by age,parity,status of assisted reproduction,and multiple pregnancies.Birthweight,gestational age at complete blood count collection,gestational age at delivery,mode of delivery,etc.were recorded.The main indices as NLR,PLR,MPV,PDW,and RDW among the groups were compared,as well as some secondary outcomes including neutrophil,platelets,and hemoglobin.RESULTS The NLR(6.4 vs 4.3 vs 3.5),MPV(11.9 vs 11.2 vs 10.7),PDW(16.4 vs 13.3 vs 14.2),leukocyte(12.4×10^(9)/L vs 9.7×10^(9)/L vs 8.7×10^(9)/L)and neutrophil count(9.9×10^(9)/L vs 7.3×10^(9)/L vs 6.1×10^(9)/L)were highest in the HELLP group,lower in the PE group,and lowest in the control group.Both the overall comparisons between the three groups(all bP<0.01)and pairwise comparisons between every two groups elicited statistically significant differences(all dP<0.01,except control vs PE:cP<0.05 in PDW).The average lymphocyte counts were 1.4(1.1,2.0)×10^(9)/L in the HELLP group,1.6(1.3,2.0)×10^(9)/L in the PE group and 1.7(1.4,2.0)×10^(9)/L in the control group.The overall comparison of lymphocyte count within the three groups had statistically significant differences(P=0.000).The pairwise comparisons between every two groups demonstrated that the HELLP group had a lower lymphocyte count than both the PE(P=0.019)and control groups(P=0.000),but the difference between the PE and control groups was not statistically significant(P=0.432).The overall comparisons on platelet counts and the PLR among these three groups also showed statistically significant differences(both P=0.000),from low to high being those in the HELLP group(43.4×10^(9)/L,64.0),control group(180.5×10^(9)/L,103.6)and PE group(181.5×10^(9)/L,112.8).Pairwise comparisons of neither index displayed statistically significant differences between the PE and control groups(both P>0.05),while the differences in the two indices between the HELLP group and the two other groups were still statistically significant(all P=0.000).RDW values were highest in the HELLP group(14.5%[13.6,15.3]),lower in the control group(14.1%[13.5,14.8])and lowest in the PE group(13.9%[13.4,14.9]).The difference between the PE and control group did not show statistical significance(P=1.000),while RDW values in the HELLP group were higher than those in the other two groups(cP<0.05 vs control,dP<0.01 vs PE).CONCLUSION SIR markers such as NLR,RDW,MPV,and PDW were increased and PLR was decreased in HELLP.These SIR markers may become new indicators in the evaluation of HELLP syndrome.
