Prognostic efficacy of RDW in patients with acute pulmonary thromboembolism for in-hospital mortality and adverse events

Introduction: Increased red cell distribution width (RDW) is linked to pulmonary thromboembolism (PTE) severity and is associated with inflammation during the acute phase of the PTE. In this study, we aimed to measure the predictive value of RDW for in-hospital mortality and major cardiopulmonary adverse events. Methods: : Data from 801 patients with the diagnosis of PTE were retrospectively reviewed. We divided patients into two groups based on experiencing Major Adverse Cardiopulmonary Events (MACPE), which includes mortality, thrombolysis, mechanical ventilation, and surgical embolectomy during hospitalization. Then the collected medical records were compared between the groups. In-hospital mortality and MACPE were our primary and secondary measured outcomes, respectively. Results: : Mean RDW was 14.28 ± 1.44 in the whole population and was higher in the MACPE group (P-value= 0.024). RDW with the cut-off point of 14.05% has both sensitivity and specificity of 54% (AUC=0.555, CI=0.509 - 0.601) in predicting in-hospital MACPE, but with the cut-off point of 13.75%, it has a higher performance in predicting in-hospital death (AUC=0.650, CI=0.575 – 0.726). Patients with the RDW ≥ 13.75% had a higher mortality rate than the others (P-value=0.003). RDW remained an independent risk factor for in-hospital mortality but not MACPE after conducting a multivariable analysis (P-value= 0.009, 0.397 resp.) Conclusion: the mortality caused by pulmonary embolism can be predicted using RDW as an easily accessible marker, but it performs poorly in predicting in-hospital MACPE.