Red cell distribution width is a predictor of all‐cause mortality in hospitalized dogs

Abstract

Objective: To determine whether RBC distribution width (RDW) is associated with an increased odds of mortality in hospitalized dogs and cats.Design: Retrospective, single-center study; data collected from 2007 to 2017. Setting: University teaching hospital.Animals: Six thousand six hundred and sixty-one animals (5183 dogs and 1478 cats). Interventions: None.Measurements and Main Results: Medical records were identified from animals presented to the emergency service and admitted to the ICU with a CBC and serum biochemistry performed on admission. Patients were stratified into quintiles based upon presenting RDW, and logistic regression modeling was performed to evaluate the relationship between RDW and in-hospital mortality. Canine patients with a presenting RDW in the upper fourth and fifth quintiles had an increased odds of all-cause inhospital mortality (p < 0.0001). Specifically, dogs in the upper fifth quintile had a 2.1fold greater odds of death compared to dogs in the first quintile, and dogs in the upper fourth quintile had a 1.9-fold greater odds of death compared to dogs in the first quintile. This relationship remained significant after adjusting for age, sex, key laboratory values excluding HCT, medical versus surgical disease, and diagnosis category. This relationship was no longer significant with the inclusion of HCT. No significant association was identified between presenting RDW and in-hospital mortality in cats. Conclusions:Hospitalized dogs with higher RDW on presentation to the emergency service have greater odds of all-cause in-hospital mortality compared to dogs with a lower RDW. A similar association between RDW and mortality was not found in cats.Further studies are warranted to assess the usefulness of this biomarker for specific diseases in dogs and to better understand the mechanisms driving the association between increased RDW and mortality in canine patients.

Prognostic Role of Red Cell Distribution Width and Other Routine Clinico-Pathological Parameters in Dogs with Acute Pancreatitis

“…Furthermore, no correlation was found between RDW and RDW/Ca, and RBC, Hb and Hct, with the only exception of weak negative correlation between RDW and Hct. The association between RDW and regenerative anemia has been demonstrated in previous studies on dogs with various systemic and cardiovascular disorders [22][23][24][25][26][27][28][29]. Our findings suggest that the increased RDW and RDW/Ca in non-survivor dogs were not correlated to anemia and confirmed that anemia was not associated with a negative prognosis in dogs with AP [1][2][3]7].…”

“…Similar results were obtained when RDW/Ca > 1.4 was used in the multivariable model instead of RDW > 12.7% (data not shown). Two recent studies reported the relationship between increased RDW and all-cause mortality in dogs with myxomatous mitral valve disease and those hospitalized for different disorders [ 25 , 29 ]. Conversely, RDW did not predict all-cause mortality in dogs with trauma and those admitted to the intensive care unit of a referral veterinary hospital for miscellaneous disorders [ 26 , 30 ].…”

“…Among them, red cell distribution width (RDW), RDW-to-total calcium ratio (RDW/Ca), neutrophils-to-lymphocytes ratio (N/L) and platelets-to-lymphocytes ratio (P/L) have been powerfully associated with negative outcome in people with AP [ 16 , 17 , 18 , 19 , 20 , 21 ]. At present, some observational studies have investigated the role of RDW in dogs with different systemic disorders, including cardiovascular disorders (myxomatous mitral valve disease and pulmonary hypertension) [ 22 , 23 , 24 , 25 ], acute trauma, heartworm disease, and dogs admitted to intensive care unit or hospitalized for medical and surgical diseases [ 26 , 27 , 28 , 29 , 30 ], providing conflicting results. The prognostic value of RDW and RDW/Ca has been poorly investigated in dogs with AP.…”

Red Blood Cell Distribution Width as a Novel Parameter in Canine Disorders: Literature Review and Future Prospective

“…Recent articles have reported the results of RDW evaluation in animals with different severe diseases [ 19 , 20 , 21 ]. Ludwik et al [ 20 ] assessed the relationship between RDW and mortality using logistic regression modeling in 6661 hospitalized animals, including 5183 dogs and 1478 cats.…”

“…Similar to the developments in human medicine, some studies investigating the use of RDW as a novel marker have also been recently published in various animal clinical settings. In particular, these studies have been conducted in small animals with cardiovascular disease [ 10 , 11 , 12 , 13 , 14 , 15 ] and other various disorders [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Therefore, the aim of this review is to provide the most relevant information on RDW evaluation in the dog.…”