Predictive Value of Red Blood Cell Distribution Width in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Embolism

Abstract

Purpose. This study is aimed at investigating the relationship between red cell distribution width (RDW) and chronic obstructive pulmonary disease (COPD) patients with pulmonary embolism (PE). Methods. We conducted a retrospective study enrolling a total of 125 patients from January 2013 to December 2019. The study group consisted of 40 COPD patients with PE, and the control group had 85 COPD patients without PE. Clinical data including demographic characteristics, comorbidities, and results of imaging examinations and laboratory tests were recorded. Blood biomarkers, including red blood cell distribution width standard deviation (RDW-SD), red blood cell distribution width coefficient of variation (RDW-CV), and D-Dimer, were included. Results. RDW-SD and RDW-CV were higher in the COPD patients with the PE group (p<0.001). A higher RDW-SD led to a significantly increased risk of PE than a lower RDW-SD (adjusted odds ratio (OR): 1.188; 95% confidence interval (CI): 1.048-1.348). The area under the curve (AUC) of RDW-SD used for predicting PE was 0.737. Using 44.55 as the cutoff value of RDW-SD, the sensitivity was 80% and the specificity was 64.7%. The prediction accuracy of RDW-SD combined with D-Dimer (AUC=0.897) was higher than that of RDW-SD or D-Dimer alone. The optimal cutoff value of RDW-SD+D-Dimer for predicting PE was 0.266, which generated a sensitivity of 87.5% and specificity of 83.5%. Conclusion. RDW is significantly increased in COPD patients with PE and may thus be useful in predicting the occurrence of PE in patients with COPD.

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

“…Consistent with previous systematic reviews [ 6 , 15 ], our study revealed that the incidence of DVT among AE-COPD was lower than that of PE. Five studies were excluded from our original analyses because they enrolled patients with COPD and not those with AE-COPD [ 38 – 42 ]. Including these five studies in the analysis yields a slight increase in PE prevalence in COPD patients (19.9%; 95% CI, 15.2%-25.7%).…”

“…PE and AE-COPD are very similar, and the two are often indistinguishable clinically. Therefore, PE is easily neglected in patients with AE-COPD, resulting in delayed treatment and poor prognosis [ 14 , 38 ]. Our study suggests that these clinical symptoms merit clinical attention and should be taken into account in patients with unexplained AE-COPD after excluding respiratory tract infection.…”

“…Wang et al . [ 38 ] discovered that the red blood cell distribution width standard deviation (RDW-SD) combined with D-dimer levels (sensitivity 87.5%, specificity 83.5%) may be useful in predicting the occurrence of PE in patients with COPD [ 56 – 58 ]. Bialas et al .…”

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

“… 23 Subsequently, Kalemci confirmed the previously reported results. 24 The RDW can also be used to predict high risk for COPD complicated with pulmonary hypertension, 25 pulmonary embolism, 26 and pulmonary heart disease. 27 A study of 307 patients concluded that the RDW also has clinical diagnostic value for depression and/or anxiety associated with AECOPD, and may become a new indicator of inflammation in AECOPD.…”

Pulmonary embolism with chronic obstructive pulmonary disease

“… 2 A population-based retrospective cohort study found that 12.31 out of 10,000 COPD patients developed PE each year, approximately four times the rate of non-COPD patients. 3 In addition, the prevalence of PE has been noted to be higher among acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients. 4 Venous thromboembolism (VTE) is a type of disease including deep vein thrombosis (DVT) and PTE.…”