Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009–2015): 129 cases

Abstract

Objective:To compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.Design: Retrospective observational study (2009)(2010)(2011)(2012)(2013)(2014)(2015).Setting: University teaching hospital. Animals:One hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury. Interventions: None.Measurements and Main Results: One hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival.Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813. Conclusions:The presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems. K E Y W O R D SnRBCs, nucleated red blood cells, RDW, serum/plasma iron, trauma Abbreviations: APPLE FAST , acute patient physiologic and laboratory evaluation score ( FAST = 5 parameter score, FULL = 10 parameter score); ATT, Animal Trauma Triage; nRBCs, nucleated red blood cells; RDW, red blood cell distribution width; ROC, receiver operating characteristic; SIRS, systemic inflammatory response syndrome.

Red Cell Distribution Width Has a Negative Prognostic Role in Dogs with Myxomatous Mitral Valve Disease

“…The effect of age on RDW deserves further prospective investigation, particularly when studying age-associated disease of dogs like MMVD. Conversely, other negative correlations of RDW observed in the present study, such as those with RBC, hematocrit, hemoglobin, and MCV were consistent with the results of several other investigations both in dogs [11][12][13][14][15] and humans [7,28,29], which further confirmed the association between RDW and regenerative anemia.…”

“…In dogs, some retrospective studies evaluated RDW in animals with several nonhematological disorders including myxomatous mitral valve disease (MMVD), PH, heartworm disease, acute trauma, and different endocrine, neurological, gastrointestinal, respiratory, and renal diseases [11][12][13][14][15][16]. MMVD is the most common canine cardiac disease and conflicting results have been reported in two successive studies that evaluated RDW in affected dogs compared with clinically healthy dogs [11,15].…”

“…MMVD is the most common canine cardiac disease and conflicting results have been reported in two successive studies that evaluated RDW in affected dogs compared with clinically healthy dogs [11,15]. Furthermore, one study evaluated the prognostic value of different hematologic variables in dogs with acute trauma, but failed to demonstrate an association between RDW and survival in these animals [14]. To the author's knowledge, no study has specifically evaluated the prognostic value of RDW in dogs with cardiac disease.…”

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

“…18 In dogs with acute trauma, RDW was not found to be significantly different between surviving and nonsurviving animals. 19 A recent study examined RDW in various canine disease processes, but no conclusions were made with regard to mortality. 20 The relationship between RDW and mortality in a critical care setting has not been reported in animal patients.…”

Red cell distribution width, illness severity, and all‐cause mortality in dogs admitted to the ICU

“…15 Most recently, a retrospective observational study evaluating 129 dogs following trauma demonstrated no association between RDW and survival. 16 To the authors' knowledge, the clinical utility of RDW in other veterinary cohorts remains to be determined. The purpose of this study was to investigate the accuracy of RDW as a predictor of illness severity and mortality in a heterogenous population of dogs admitted to the ICU.…”