Increased red cell distribution width: A novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease

Background: Acute exacerbation of COPD (AECOPD) is one of the leading causes for hospitalization and readmission in developed countries. No laboratory indices were consistently found to be associated with readmission risk. Recent evidence attests that red blood cell distribution width (RDW), conveys important information for short and long term prognosis in a variety of medical conditions. Prognostic usefulness of RDW in patients with AECOPD has not been investigated.

Objective: To evaluate the usefulness of RDW in predicting early adverse outcomes in patients hospitalized due to AECOPD.

Methods: Patients hospitalized for AECOPD between 2011 and 2013 were revised. Clinical and laboratory parameters were noted. Participants were followed to determine the incidence of readmission due to AECOPD, readmission from any cause and composite end point of readmission or death during 60 days after discharge.

Results: 539 patients were included in the study. The 60-day overall readmission rate was 26.35%, of that, 41.55% were due to AECOPD. The Presence of heart failure, pH below 7.35 at discharge and abnormal RDW were associated with the composite endpoint. The negative predictive value of normal RDW was 80.12%.

Conclusion: Increased RDW is an independent negative prognostic factor associated with adverse outcomes after hospitalization due to AECOPD.