Red Blood Cell Distribution Width in Patients with Chronic Obstructive
Lung Diseases: Alteration due to Severity of Exacerbation
Abstract
Background: Elevated red blood cell distribution width (RDW) levels were
associated with mortality in patients with stable chronic obstructive
lung diseases (COPD). There are limited data about RDW levels in COPD
exacerbation. Aim/Objective: The association of the RDW levels with the
severity of the acute exacerbation of COPD (AECOPD) were evaluated
according to admission location, (outpatient-clinic, ward and intensive
care unit (ICU). Methods: Cross sectional retrospective study designed
in tertiary chest dieases hospital. COPD patients admitted to hospital
outpatiens-clinic, ward and ICU due to AECOPD were included. Patients
demographics, RDW, C-reactive protein (CRP), biochemistry values were
recorded. RDW values were subdivided below 0.11% (low), above and equal
0.15% (high) and between 0.11-0.15% (normal). Neutrophile to
lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV)
were also calculated. Recorded values were compared according to where
AECOPD was treated. Results: 2771 COPD patients (33% female) and 1429
outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study.
The median RWD values in outpatients-clinic, ward and ICU were 0.16
(0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively
(p<0.001). In outpatient to ward and ICU, low RDW values were
significantly increased (31%, 66%, 83% respectively) and high RDW
values significantly decreased (54%, 24%, 10%) (p<0.001).
According to attack severity, low RDW values were determined.
Conclusion: Patients with AECOPD, lower RDW values should be considered
carefully. Lower RDW can be used for decision of COPD exacerbation
severity and follow up treatment response. What is already known about
this topic; In current studies, elevated RDW levels were associated with
mortality in patients with stable COPD. What does this article add;
Currently , there are limited data about RDW levels in COPD
exacerbation. In the present study, the association of the RDW levels
according to the severity of AECOPD were evaluated due to admission
location.