Dynamic Increase of Red Cell Distribution Width Predicts Increased Risk of 30-Day Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Purpose

Studies have demonstrated that red blood cell distribution width (RDW) is closely associated with the prognosis of patients with chronic obstructive pulmonary disease (COPD). In addition, the dynamic changes in RDW appear to play an important role. Thus, we aimed to investigate the relationship between dynamic changes in RDW and 30-day all-cause readmission of patients with acute exacerbation of COPD (AECOPD).

Methods

In this retrospective cohort study, we enrolled patients with AECOPD hospitalized in the Department of Respiratory Medicine in Liyuan Hospital (Wuhan China), a tertiary, university-affiliated, public hospital. Patients with AECOPD were divided into three groups based on their RDW values after the first and fourth days of admission. The normal range for RDW is 10–15%. Patients with normal RDW values were included in the normal group. Patients with an RDW value >15% on the first day, which subsequently decreased by >2% on the fourth day was included in the decreased group. The increased group was comprised of patients with an RDW value >15% on the first day which continued to increase, or those with a normal RDW value on the first day which increased >15% on the fourth day.

Results

A total of 239 patients (age: 72 years [range: 64–81 years]; male: n=199 [83.3%]) were included. There were 108, 72, and 59 patients in the RDW normal, decreased, and increased groups, respectively; the 30-day all-cause readmission rate was 9.3%, 9.7%, 27.1%, respectively; (p=0.003), being noticeably higher in the RDW increased group. Dynamic increase of RDW (OR:3.45, 95% CI: 1.39–8.58, p= 0.008) was independently correlated with 30-day all-cause readmission of patients with AECOPD.

Conclusion

The dynamic increase of RDW is an independent prognostic factor of 30-day all-cause readmission of patients with AECOPD.

Keywords:

• RDW
• chronic obstructive pulmonary disease
• hospitalization
• readmission
• prognosis

Abbreviations

RDW, red cell distribution width; COPD, chronic obstructive pulmonary disease; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; OR, odds ratios; 95% CI, 95% confidence intervals.

Data Sharing Statement

Data for this study are available from the corresponding author.

Acknowledgments

Thanks to Yulan Zeng MD for her suggestions on the revision of the article and her help with the language editing.

Disclosure

The authors report no conflicts of interest.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.