Abstract 15519: Red Cell Distribution Width Predicts Inflammatory Conditions After Cardiovascular Surgery
Background: Red cell distribution width (RDW), a measure of erythrocyte size heterogeneity, has been identified as an independent risk factor for mortality and morbidity in cardiovascular disease and poor outcome in sepsis patients. We therefore hypothesized that elevated preoperative RDW levels are an independent risk factor for postoperative inflammatory conditions in cardiovascular surgery patients.
Methods: RDW was measured in 2708 patients undergoing isolated coronary artery bypass grafting (CABG) surgery and 160 patients undergoing open abdominal aortic aneurysm (AAA) repair between 2007 and 2013 in a single Dutch university hospital. Baseline patient characteristics and complication registry were obtained from in-hospital digital patient charts. The composite inflammatory condition consisted of all postoperative inflammatory in-hospital complications, including pneumonia, sepsis, multi-organ failure, and renal failure. Univariable and multivariable logistic regression analyses were performed in order to determine associations between RDW and the development of postoperative inflammatory conditions.
Results: In total, 85 (3.4%) and 43 patients (31.6%) developed a postoperative inflammatory condition after CABG and AAA-repair, respectively. The majority of inflammatory conditions consisted of pneumonias in both the CABG-cohort (68 patients (2.7%)) and in the AAA-cohort (35 patients (25.7%)). After adjustment for possible confounders, RDW was independently associated with postoperative inflammatory conditions in both the CABG- (OR 1.19(95% CI 1.07-1.32) p=0.001) and in the AAA-cohort (OR 1.80(95% CI 1.23-2.61) p=0.002) for every increment of 1 percent in RDW.
Conclusion: The RDW is an independent preoperative risk factor for the development of postoperative inflammatory conditions in cardiovascular surgery patients. Measurements of RDW could be used to initiate preventive therapy for inflammatory complications in high risk cardiovascular patients. Further research is needed to show that RDW guided preventive therapy indeed reduces complications during follow-up.
- Cardiovascular disease
- Coronary artery bypass grafting (CABG)
- Abdominal aortic aneurysm
Author Disclosures: I.D. van Koeverden: None. I.E. Hoefer: None. H. den Ruijter: None. M. de Groot: None. G. Pasterkamp: None.
- © 2016 by American Heart Association, Inc.