Red cell distribution width in acute pulmonary embolism patients: A simple aid for improvement of the 30-day mortality risk stratification based on the pulmonary embolism severity index

Jurin, Ivana; Trkulja,; Ajduk, Marko; Letilović, Tomislav; Hadžibegović, Irzal

doi:10.1016/j.hrtlng.2019.02.006

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…PE pathophysiology reflects dysregulation of coagulation, inflammatory and hematologic processes. 17 , 18 , 22 There is growing evidence of laboratory parameters predictive of all-cause mortality, including MPV, 14 , 23 , 24 blood cellular ratios, 12 , 13 , 23 , 25 RDW, 15 and anemia, 11 few studies have incorporated multiple parameters into existing risk prediction models. It is necessary to further explore using blood cellular indices to predict all-cause mortality to improve current PE treatment algorithms.…”

Section: Discussionmentioning

confidence: 99%

“…There is growing literature demonstrating the utility of individual blood cellular indices obtained from complete blood counts in predicting PE patient prognosis. [11][12][13][14][15] Venous thromboembolisms occur in part due to complex inflammatory and coagulation processes associated with platelet activation and inflammatory cascades. 16,17 There are increased levels of pro-inflammatory cytokines as well as evolving ratios of immune cells interacting with the thrombus itself.…”

Section: Introductionmentioning

confidence: 99%

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Utility of Blood Cellular Indices in the Risk Stratification of Patients Presenting with Acute Pulmonary Embolism

Slajus

Brailovsky

Darwish

et al. 2021

Clin Appl Thromb Hemost

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Pulmonary embolism (PE) clinical manifestations vary widely, and that scope is not fully captured by current all-cause mortality risk models. PE is associated with inflammatory, coagulation, and hemostatic imbalances so blood cellular indices may be prognostically useful. Complete blood count (CBC) data may improve current risk models like the simplified pulmonary embolism severity index (sPESI) for all-cause mortality, offering greater accuracy and analytic ability. Acute PE patients (n = 228) with confirmatory diagnostic imaging were followed for all-cause mortality. Blood cellular indices were assessed for association to all-cause mortality and were supplemented into sPESI using multivariate logistic regression. Multiple blood cellular indices were found to be significantly associated with all-cause mortality in acute PE. sPESI including red cell distribution width, hematocrit and neutrophil-lymphocyte ratio had better predictive ability as compared to sPESI alone (AUC: 0.852 vs 0.754). Blood cellular indices contribute an inflammatory and hemodynamic perspective not currently included in sPESI. CBC with differential is a widely used, low-cost test that can augment current risk stratification tools for all-cause mortality in acute PE patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utility of Blood Cellular Indices in the Risk Stratification of Patients Presenting with Acute Pulmonary Embolism

Slajus

Brailovsky

Darwish

et al. 2021

Clin Appl Thromb Hemost

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“…The mechanism of inflammatory reactions is closely related to the occurrence and development of thromboembolism [10]. In recent years, many researchers have reported that some predictors based on inflammation are associated with prognosis in patients with pulmonary embolism, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-tolymphocyte ratio (MLR), red blood cell distribution width (RDW), and C-reactive protein (CRP) [11][12][13][14]. In addition, the relationship between nutritional status and prognosis in patients with pulmonary embolism has also been extensively studied in a previous study [15].…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

et al. 2020

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Background This retrospective study aimed to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism (PAPE). Methods We retrospectively reviewed the medical records of 101 patients with PAPE admitted from September 1, 2012, to March 31, 2019. The characteristics, surgical information, admission examination data and mortality within 30 days after PAPE were obtained from our electronic medical recording system and follow-up. The associations between the NLR, PLR, and other predictors and 30-day mortality were analyzed with univariate and multivariate analyses. Then, the nomogram including the independent predictors was established and evaluated. Results Twenty-four patients died within 30 days, corresponding to a 30-day mortality rate of 23.8%. The results of the multivariate analysis indicated that both the NLR and albumin were independent predictors for 30-day mortality in patients with PAPE. The probability of death increased by approximately 17.1% (OR = 1.171, 95% CI: 1.073–1.277, P = 0.000) with a one-unit increase in the NLR, and the probability of death decreased by approximately 15.4% (OR = 0.846, 95% CI: 0.762c–0.939, P = 0.002) with a one-unit increase in albumin. The area under the curve of the nomogram was 0.888 (95% CI: 0.812–0.964). Conclusion Our findings showed that an elevated NLR and decreased albumin were related to poor prognosis in patients with PAPE. The NLR and albumin were independent prognostic factors for PAPE.

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“…The mechanism of in ammatory reactions is closely related to the occurrence and development of thromboembolism [10]. In recent years, many researchers have reported that some predictors based on in ammation are associated with prognosis in patients with pulmonary embolism, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width (RDW), and C-reactive protein (CRP) [11][12][13][14]. In addition, the relationship between nutritional status and prognosis in patients with pulmonary embolism has also been extensively studied in a previous study [15].…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

Liu

Zhan

Huang

et al. 2020

Preprint

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Background: This retrospective study aimed to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism (PAPE).Methods: We retrospectively reviewed the medical records of 101 patients with PAPE admitted from September 1, 2012, to March 31, 2019. The characteristics, surgical information, admission examination data and mortality within 30 days after PAPE were obtained from our electronic medical recording system and follow-up. The associations between the NLR, PLR, and other predictors and 30-day mortality were analyzed with univariate and multivariate analyses. Then, the nomogram including the independent predictors was established and evaluated.Results: Twenty-four patients died within 30 days, corresponding to a 30-day mortality rate of 23.8%. The results of the multivariate analysis indicated that both the NLR and albumin were independent predictors for 30-day mortality in patients with PAPE. The probability of death increased by approximately 17.1% (OR=1.171, 95% CI: 1.073–1.277, P=0.000) with a one-unit increase in the NLR, and the probability of death decreased by approximately 15.4% (OR=0.846, 95% CI: 0.762c–0.939, P=0.002) with a one-unit increase in albumin. The area under the curve of the nomogram was 0.888 (95% CI: 0.812-0.964).Conclusion: Our findings showed that an elevated NLR and decreased albumin were related to poor prognosis in patients with PAPE. The NLR and albumin were independent prognostic factors for PAPE.

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Red cell distribution width in acute pulmonary embolism patients: A simple aid for improvement of the 30-day mortality risk stratification based on the pulmonary embolism severity index

Cited by 13 publications

References 16 publications

Utility of Blood Cellular Indices in the Risk Stratification of Patients Presenting with Acute Pulmonary Embolism

Utility of Blood Cellular Indices in the Risk Stratification of Patients Presenting with Acute Pulmonary Embolism

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

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