Title of article :
Red blood cell distribution width as a predictor of long-term mortality in patients with carbon monoxide poisoning
Author/Authors :
Açıkel, Sadık Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Sunman, Hamza Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Çimen, Tolga Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Erat, Mehmet Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Yayla, Kadriye Gayretli Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Efe, Tolga Han Department of Cardiology - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Özkan, Seda Department of Emergency Medicine - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey , Arslan, Engin Deniz Department of Emergency Medicine - University of Health Sciences - Dıs ̧kapıYıldırım Beyazıt Training and Research Hospital - Ankara, Turkey
Abstract :
Elevated red blood cell distribution width (RDW) is an independent prognostic factor for cardiovascular events that are major causes of mortality in patients with carbon monoxide (CO) poisoning. Due to the limited number of studies, we aimed to investigate the relationship between RDW levels and long-term mortality for these patients.
Method
This retrospective study included patients with CO poisoning, who presented to the emergency department. Baseline characteristics, laboratory results and survival status were retrieved from patients' hospital records. The severity of poisoning was determined according to COHb level and/or clinical signs and symptoms.
Results
The study included 571 patients (median age was 37.0 years) and less than half of these patients were male (n = 206, 36.1%). There were mild-moderate CO poisoning in 389 (68.1%) patients and severe poisoning in 182 (31.9%). At a median follow-up of 6.2 years, there were 33 deaths (5.8%). Univariate cox-regression analysis demonstrated that age, gender, presence of hypertension or diabetes mellitus, levels of hemoglobin, RDW, creatinine and alanine-aminotransferase, and white-blood-cell count were potential covariates of long-term all-cause mortality. In the multivariate analysis, the median age and RDW level remained independent predictors of mortality (age, Odds ratio [OR]: 1.070 95% confidence interval [CI]: 1.030–1.110, p = 0.001; RDW, OR: 1.221 95% CI: 1.042–1.431, p = 0.013). Patients with higher RDW levels had a significantly worse prognosis in terms of mortality than with lower RDW levels (log-rank test, p = 0.003).
Conclusion
This study demonstrated that RDW level is an independent predictor of long-term mortality in patients with CO poisoning.
Keywords :
Long-term mortality , Red blood cell distribution width , Carbon monoxide poisoning
Journal title :
Turkish Journal of Emergency Medicine