Background: Pulmonary embolism (PE) severity index (PESI) well predicts 30-day mortality in acute PE patients, yet improvements have been advocated.
Objectives: To evaluate predictivity of the red cell distribution width (RDW) through a comparison with PESI and to explore their interaction as a potential improvement in this respect.
Methods: Retrospective analysis of consecutive adult PE patients.
Results: Of the 299 patients, 19 severely unstable died within 48 h. Among the stabilized patients, 30-day mortality was 12.1% (34/280). With PESI ≤125, mortality was 4.9% (9/185), but it was 0.7% (1/140) if RDW ≤15.0% and 17.8% (8/45) if RDW >15.0%; with PESI >125, mortality was 26.3% (25/95), but it was 15.9% (7/44) if RDW ≤15.0% and 35.3% (18/51) if RDW >15.0%. Adjusted relative risk with PESI >125 vs. ≤125 was 17.5 (95%CI 2.37-129) at RDW ≤15.0% and 1.60 (0.76-3.36) at RDW >15.0%.
Conclusions: Thirty-day mortality predictions based on the PESI score may be improved by accounting for RDW.
Keywords: 30-day mortality; Acute pulmonary embolism; Pulmonary embolism severity index; Red cell distribution width.
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