Red blood cell distribution width: a potential prognostic index for short-term mortality of patients admitted to emergency department for acute decompensation of liver cirrhosis?

Red blood cell distribution width: a potential prognostic index for short-term mortality of... Letter to the Editor However, the medications might significantly affect the Red blood cell distribution width: a potential short-term mortality of patients admitted to the ED for AD prognostic index for short-term mortality of of liver cirrhosis. Furthermore, some medications may also patients admitted to emergency department affect the RDW levels [6]. Thus, more details of the patients’ for acute decompensation of liver cirrhosis? medications would have been beneficial. Therefore, prospective studies with well-defined inclu- Rui Huang, Juan Xia, Jian Wang, Zhaoping Zhang and Chao Wu, Department sion and exclusion criteria are required to validate the of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of predictive values of RDW for the risk of short-term mor- Nanjing University Medical School, Nanjing, Jiangsu Province, China tality of AD patients of liver cirrhosis after ED admission. Correspondence to Chao Wu, MD, PhD, Department of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical Acknowledgements School, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China Tel: + 86 25 8310 5890; fax: + 86 25 8330 7115; e-mail: dr.wu@nju.edu.cn The study was supported by the National Natural Science Foundation of China (81672025 and 81702011), Medical Science and Technology Development Foundation of Nanjing (ZDX16004 and YKK16118), Jiangsu Provincial Received 31 October 2017 Accepted 3 November 2017 Medical Innovation Team (CXTDA2017005), Natural Science Foundation of Jiangsu Province for Young Scholar (BK20160121) and Nanjing Medical Science and We read with great interest the article by Turcato et al. [1]. Technique Development Foundation (QRX17121). They conducted a retrospective study to explore the predictive values of red blood cell distribution width (RDW) for the risk of short-term mortality of patients admitted to the emergency Conflicts of interest department (ED) for acute decompensation (AD) of liver There are no conflicts of interest. cirrhosis [1]. They concluded that RDW could independently predict 1-month mortality of patients with AD cirrhosis admitted to the ED [1]. The study is very interesting. However, References we feel that several issues deserve further discussion. 1 Turcato G, Campagnaro T, Bonora A, Vignola N, Salvagno GL, RDW is an inexpensive parameter which reflects Cervellin G, et al. Red blood cell distribution width independently predicts volume heterogeneity of circulating erythrocytes and has 1-month mortality in acute decompensation of cirrhotic patients admitted to emergency department. Eur J Gastroenterol Hepatol 2018; 30:33–38. received growing attention. However, the RDW levels are 2 Karagöz E, Tanoglu A. Red blood cell distribution width: a potential easily affected by many confounding factors such as age prognostic index for liver disease? Clin Chem Lab Med 2014; 52: and malnutrition [2]. Furthermore, RDW has been e201. demonstrated to be an independent index of prognosis in 3 Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a patients with several cardiovascular diseases such as heart prognostic marker in heart failure. J Card Fail 2010; 16:230–238. failure, myocardial infarction and stroke [3–5]. As pre- 4 Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between sented in table 1, by the univariate analysis, the numbers of red cell distribution width and clinical outcomes after acute myocardial patients with comorbidity of heart failure between the infarction. Am J Cardiol 2010; 105:312–327. survived patients and those who died within 30 days after 5 Fan L, Gui L, Chai EQ, Wei CJ. Routine hematological parameters are associated with short- and long-term prognosis of patients with ED admission were significantly different. Thus, the results ischemic stroke. J Clin Lab Anal 2017. [Epub ahead of print]. would be more convincing if the author had excluded 6 Fici F, Celik T, Balta S, Iyisoy A, Unlu M, Demitkol S, et al. Comparative patients with comorbidities of cardiovascular diseases such effects of nebivolol and metoprolol on red cell distribution width and as heart failure or added these comorbidities in the neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension. J Cardiovasc Pharmacol 2013; 62:388–393. multivariate analysis. In addition, the medications for AD patients of liver cirrhosis after ED admission were not provided in the study. DOI: 10.1097/MEG.0000000000001042 European Journal of Gastroenterology & Hepatology 2018, 30:328 0954-691X Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. 328 Copyright r 2018 Wolters Kluwer Health, Inc. All rights reserved. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Gastroenterology & Hepatology Wolters Kluwer Health

Red blood cell distribution width: a potential prognostic index for short-term mortality of patients admitted to emergency department for acute decompensation of liver cirrhosis?

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Wolters Kluwer Health
Copyright
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0954-691X
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1473-5687
D.O.I.
10.1097/MEG.0000000000001042
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Abstract

Letter to the Editor However, the medications might significantly affect the Red blood cell distribution width: a potential short-term mortality of patients admitted to the ED for AD prognostic index for short-term mortality of of liver cirrhosis. Furthermore, some medications may also patients admitted to emergency department affect the RDW levels [6]. Thus, more details of the patients’ for acute decompensation of liver cirrhosis? medications would have been beneficial. Therefore, prospective studies with well-defined inclu- Rui Huang, Juan Xia, Jian Wang, Zhaoping Zhang and Chao Wu, Department sion and exclusion criteria are required to validate the of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of predictive values of RDW for the risk of short-term mor- Nanjing University Medical School, Nanjing, Jiangsu Province, China tality of AD patients of liver cirrhosis after ED admission. Correspondence to Chao Wu, MD, PhD, Department of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical Acknowledgements School, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China Tel: + 86 25 8310 5890; fax: + 86 25 8330 7115; e-mail: dr.wu@nju.edu.cn The study was supported by the National Natural Science Foundation of China (81672025 and 81702011), Medical Science and Technology Development Foundation of Nanjing (ZDX16004 and YKK16118), Jiangsu Provincial Received 31 October 2017 Accepted 3 November 2017 Medical Innovation Team (CXTDA2017005), Natural Science Foundation of Jiangsu Province for Young Scholar (BK20160121) and Nanjing Medical Science and We read with great interest the article by Turcato et al. [1]. Technique Development Foundation (QRX17121). They conducted a retrospective study to explore the predictive values of red blood cell distribution width (RDW) for the risk of short-term mortality of patients admitted to the emergency Conflicts of interest department (ED) for acute decompensation (AD) of liver There are no conflicts of interest. cirrhosis [1]. They concluded that RDW could independently predict 1-month mortality of patients with AD cirrhosis admitted to the ED [1]. The study is very interesting. However, References we feel that several issues deserve further discussion. 1 Turcato G, Campagnaro T, Bonora A, Vignola N, Salvagno GL, RDW is an inexpensive parameter which reflects Cervellin G, et al. Red blood cell distribution width independently predicts volume heterogeneity of circulating erythrocytes and has 1-month mortality in acute decompensation of cirrhotic patients admitted to emergency department. Eur J Gastroenterol Hepatol 2018; 30:33–38. received growing attention. However, the RDW levels are 2 Karagöz E, Tanoglu A. Red blood cell distribution width: a potential easily affected by many confounding factors such as age prognostic index for liver disease? Clin Chem Lab Med 2014; 52: and malnutrition [2]. Furthermore, RDW has been e201. demonstrated to be an independent index of prognosis in 3 Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a patients with several cardiovascular diseases such as heart prognostic marker in heart failure. J Card Fail 2010; 16:230–238. failure, myocardial infarction and stroke [3–5]. As pre- 4 Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between sented in table 1, by the univariate analysis, the numbers of red cell distribution width and clinical outcomes after acute myocardial patients with comorbidity of heart failure between the infarction. Am J Cardiol 2010; 105:312–327. survived patients and those who died within 30 days after 5 Fan L, Gui L, Chai EQ, Wei CJ. Routine hematological parameters are associated with short- and long-term prognosis of patients with ED admission were significantly different. Thus, the results ischemic stroke. J Clin Lab Anal 2017. [Epub ahead of print]. would be more convincing if the author had excluded 6 Fici F, Celik T, Balta S, Iyisoy A, Unlu M, Demitkol S, et al. Comparative patients with comorbidities of cardiovascular diseases such effects of nebivolol and metoprolol on red cell distribution width and as heart failure or added these comorbidities in the neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension. J Cardiovasc Pharmacol 2013; 62:388–393. multivariate analysis. In addition, the medications for AD patients of liver cirrhosis after ED admission were not provided in the study. DOI: 10.1097/MEG.0000000000001042 European Journal of Gastroenterology & Hepatology 2018, 30:328 0954-691X Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. 328 Copyright r 2018 Wolters Kluwer Health, Inc. All rights reserved.

Journal

European Journal of Gastroenterology & HepatologyWolters Kluwer Health

Published: Mar 1, 2018

References

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