• Br J Anaesth · Jun 2020

    A retrospective cohort study on the association between elevated preoperative red cell distribution width and all-cause mortality after noncardiac surgery.

    • Halldor B Olafsson, Gissur A Sigurdarson, Kenneth B Christopher, Sigurbergur Karason, Gisli H Sigurdsson, and Martin I Sigurdsson.
    • Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
    • Br J Anaesth. 2020 Jun 1; 124 (6): 718-725.

    BackgroundElevated red cell distribution width (RDW) has been associated with worse outcomes in several medical patient populations. The aim of this study was to investigate the association of increased preoperative RDW and short- and long-term mortality after noncardiac surgery.MethodsThis investigation was a retrospective cohort study including all patients undergoing noncardiac surgery between 2005 and 2015 at Landspitali-the National University Hospital in Iceland. Patients were separated into five predefined groups based on preoperative RDW (≤13.3%, 13.4-14.0%, 14.1-14.7%, 14.8-15.8%, and >15.8%). The primary outcome was all-cause long-term mortality and secondary outcomes included 30-day mortality, length of stay, and readmissions within 30 days, compared with propensity score matched (PSM) cohort from patients with RDW ≤13.3%.ResultsThere was a higher hazard of long-term mortality for patients with RDW between 14.8% and 15.8% (hazard ratio=1.33; 95% confidence interval, 1.15-1.59; P<0.001) and above 15.8% (hazard ratio=1.66; 95% confidence interval, 1.41-1.95; P<0.001), compared with matched controls with RDW ≤13.3%. This association held in multiple patient subgroups. For secondary outcomes, there was no difference in 30-day mortality, length of stay, or risk of readmission within 30 days.ConclusionsIncreased preoperative RDW is associated with increased long-term mortality after noncardiac surgery. RDW could be a composite biomarker of pre-existing chronic inflammation and poor nutritional status. Future studies should clarify if this is a modifiable risk factor for improved surgical outcomes.Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…