Usefulness of elevated red cell distribution width for predicting systemic inflammatory response syndrome after...

Area of Science:

• Cardiovascular Surgery
• Critical Care Medicine
• Hematology

Background:

• Cardiac surgery with extracorporeal circulation (ECC) can induce a systemic inflammatory response (SIR), potentially progressing to severe systemic inflammatory response syndrome (SIRS).
• Predictive tools for SIRS following ECC are limited, despite its poor outcomes.

Purpose of the Study:

• To investigate the association between elevated Red Cell Distribution Width (RDW) and the development of SIRS in patients undergoing cardiac surgery with ECC.
• To determine if RDW can serve as a predictive marker for SIRS in this patient population.

Main Methods:

• Retrospective analysis of 1100 consecutive patients undergoing elective heart surgery with ECC.
• Comparison of RDW and other clinical/laboratory parameters between 19 SIRS patients and 20 control patients.

Main Results:

• Patients who developed SIRS had significantly higher RDW levels compared to the control group (15.02 ± 2.03 vs 13.01 ± 1.93, p < 0.003).
• High RDW levels (exceeding 13.5%) were associated with an increased risk of SIRS development (OR: 1.0-1.3, p < 0.04).
• Higher mortality was observed in the SIRS group (94.73%) versus the control group (10%, p < 0.002).

Conclusions:

• Increased RDW is significantly associated with a higher risk of developing SIRS after extracorporeal circulation in cardiac surgery.
• RDW monitoring may offer a cost-effective clinical tool for predicting SIRS in patients undergoing open-heart surgery.