RED BLOOD CELL DISTRIBUTION WIDTH IN THE ASSESSMENT OF EARLY MORTALITY RISK IN PATIENTS WITH ACUTE PULMONARY EMBOLISM
Keywords:
Pulmonary embolism, red blood cell distribution width, early mortalityAbstract
Introduction: Pulmonary embolism (PE) is a life-threatening condition with variable clinical presentation and prognosis. Early identification of patients at increased risk of mortality remains a challenge, especially in intermediate-risk categories. Red blood cell distribution width (RDW), a routinely measured hematologic parameter, has emerged as a potential prognostic marker in various cardiovascular conditions.
Aim: To evaluate the predictive value of RDW for early (30-day) mortality in patients with acute PE.
Material and methods: This retrospective study included 58 consecutive patients with CTPA-confirmed acute PE treated at a tertiary cardiac center between 2023 and 2024. Patients were stratified into early mortality risk groups according to the 2019 ESC guidelines. RDW and other hematologic and biochemical parameters were recorded on admission. Correlation, logistic regression, and receiver operating characteristic (ROC) analyses were used to assess associations with 30-day mortality.
Results: Seven patients (12.1%) died within 30 days. RDW values were significantly higher among non-survivors with a moderate positive correlation with mortality (r=0.363, p=0,005). ROC analysis revealed an AUC of 0.771 for RDW in predicting early mortality, with an optimal cut-off of ≥14.05% (sensitivity 83.3%, specificity 59.6%). In logistic regression, RDW was an independent predictor of 30-day mortality (OR 1.637, 95% CI: 1.058-2.535; p= 0.027). Traditional clinical scores such as PESI and sPESI were not significantly associated with mortality.
Conclusion: RDW is an independent, easily obtainable predictor of early mortality in acute PE and may enhance risk stratification, particularly in intermediate-risk patients. Its integration into clinical assessment could improve early decision-making and patient management.
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