scholarly journals The Utility of Red Cell Distribution Width as a Parameter for Calculating Indices of Allostatic Load

2016 ◽  
Author(s):  
Ghalib A Bello ◽  
Gerard G Dumancas
Keyword(s):  
Health Status ◽  
Allostatic Load ◽  
Goodness Of Fit ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Cell Distribution ◽  
Strong Correlations ◽  
Distribution Width ◽  
Clinical Biomarkers ◽  
Current Formulation

AbstractBackgroundAllostatic Load is a construct used to quantify the cumulative burden of exposure to stressors that, over the course of an individual’s life, exert a toll on the body’s physiological functions, increasing risks of various chronic ailments and conditions. Studies attempting to quantify allostatic load have used a variety of clinical biomarkers representing primary and secondary mediators. In this study, we demonstrate the value of including red blood cell distribution width (RDW) among the panel of clinical parameters used to calculate allostatic load.MethodsWe develop a novel formulation of allostatic load using RDW and other standard biomarkers. This index is computed using clinical laboratory data from the NHANES study. The predictive validity of the new index for tertiary outcomes (all-cause mortality and physician-assessed health status) is compared to that of the current formulation using Harrell’s C index, ROC analysis and regression-based goodness-of-fit measures.ResultsInclusion of RDW as an allostatic load biomarker yields a significantly improved index. It demonstrates a superior ability to predict mortality, health status and biological age than the standard formulation currently in use.ConclusionRDW has shown strong correlations with mortality and a broad spectrum of diseases. A review of the existing literature on allostatic load reveals its underutilization in this area, despite being a standard component of blood count panels. This study is the first to demonstrate its usefulness as a potential allostatic load biomarker.

Admission Red Cell Distribution Width: A Novel Predictor of Massive Transfusion after Injury

2014 ◽  
Vol 80 (7) ◽  
pp. 685-689 ◽  
Author(s):  
Elena M. Paulus ◽  
Jordan A. Weinberg ◽  
Louis J. Magnotti ◽  
John P. Sharpe ◽  
Thomas J. Schroeppel ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Health Status ◽  
Massive Transfusion ◽  
Red Cell Distribution Width ◽  
Trauma Patients ◽  
Red Cell ◽  
Cell Distribution ◽  
Major Hemorrhage ◽  
Distribution Width ◽  
Chronic Health Status

Admission red cell distribution width (aRDW) has been shown to predict mortality in trauma patients by an unclear mechanism. It has been speculated that aRDW is a marker of chronic health status, but elevated RDW may also reflect recent hemorrhage. We hypothesized that aRDW is a predictor of major hemorrhage in trauma patients. Shock trauma patients at a Level I trauma center over 6.5 years were evaluated. Patients were stratified by aRDW quintile (Q1: less than 13%, Q2: 13.1 to 13.5%, Q3: 13.6 to 14.0%, Q4: 14.1 to 14.9%, Q5: 15.0% or greater). Massive transfusion (MT) was defined as 10 or more packed red blood cells in the first 24 hours. From multiple logistic regression, odds ratios with 95 per cent confidence intervals (CIs) were determined to evaluate the association between aRDW quintile and MT. Three thousand nine hundred ninety-four met study criteria. Overall MT incidence was 10 per cent and in-hospital mortality was 17 per cent. MT and mortality increased in a stepwise fashion by aRDW quintile ( P < 0.0001). From logistic regression, a threefold increased odds of MT was associated with aRDW Q4 (CI, 1.81 to 4.92), and a 3.5-fold increased odds of MT was associated with aRDW Q5 (CI, 2.70 to 5.83). aRDW independently predicted MT, suggesting that elevated aRDW is an indicator of major hemorrhage in trauma patients. The association between aRDW and mortality in trauma patients may be explained by acute hemorrhage rather than chronic health status.

scholarly journals MO450ANEMIC PATIENTS WITH ELEVATED RED CELL DISTRIBUTION WIDTH (RDW) ARE LIKELY TO HAVE FASTER FUTURE CKD PROGRESSION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Hiroshi Tanaka
Keyword(s):  
Blood Cells ◽  
Laboratory Data ◽  
Red Cell Distribution Width ◽  
First Year ◽  
Red Cell ◽  
Cell Distribution ◽  
Ckd Progression ◽  
Distribution Width ◽  
Annual Decline ◽  
Egfr Decline

Abstract Background and Aims Elevation in red cell distribution width (RDW), a marker of size variance in red blood cells, recently has been reported to predict future cardiovascular event. RDW elevation has also been reported to be associated with faster CKD progression. It is not known whether the elevation of RDW is merely a sequela of, or truly a predictor of, the decline in kidney function. Method A hospital-wide study with all the laboratory data for a period of 4 years and 2 months was conducted. All the adult patients in whom an eGFR slope was obtained over 731 days or more with haemoglobin (Hb) measurements of at least twice over 731 days or more were included. Hb and RDW values were classified according to the timing of measurement: first-year measurements during the period vs last-year values. The effects of Hb and RDW on the annual decline in eGFR (mL/min/1.73m2/year) were analyzed. Statistical analysis was performed with R 3.6.0 on Ubuntu. Results A total of 4,611 patients (M:F = 2124:2487, age 18-105 (median 68) years) were included. The first-month Hb and RDW were 7.5 − 20.2 (median 13.6) g/dL and 10.5 − 34.6 (median 12.6). eGFR was 3.4 − 195 (median 69.3) mL/min/1.73m2. Patients with the highest tertile in the first-year RDW had significantly faster decline in eGFR than the rest (-1.74 vs -1.51, P=0.04), while patients with the highest tertile in the last-year RDW had virtually identical eGFR decline compared with the rest. Patients with higher RDW (&gt;=median) and lower Hb (&lt; median) had significantly faster decline in eGFR than the rest (-1.84±4.11 vs -1.47±2.95, P =0.002). Conclusion Anemic patients with elevated RDW are likely to have faster CKD progression in the future.

scholarly journals An Objective Metric of Individual Health And Aging For Population Surveys

2021 ◽  
Author(s):  
Qing Li ◽  
Véronique Legault ◽  
Vincent-Daniel Girard ◽  
Luigi Ferrucci ◽  
Linda P. Fried ◽  
...  
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
Allostatic Load ◽  
Individual Health ◽  
Clinical Biomarkers ◽  
Physiological Dysregulation ◽  
Objective Metrics ◽  
Different Populations ◽  
Self Assessed Health ◽  
Better Than

Abstract Background: Generalized, biomarker-based metrics of health status have numerous applications in fields ranging from sociology and economics to clinical research. We recently proposed a novel metric of health status based on physiological dysregulation measured as a Mahalanobis distance (DM) among clinical biomarkers. While DM was not particularly sensitive to the choice of biomarkers, it required calibration when used in different populations, making it difficult to compare findings across studies. To facilitate its use, here we aimed to identify and validate a standard version of DM that would be highly stable across populations, while using fewer biomarkers drawn exclusively from common blood panels. Methods: Using three datasets, we identified nine-biomarker (DM9) and seventeen-biomarker (DM17) versions of DM, choosing biomarkers based on their consistent levels across populations. We validated them in a fourth dataset. We assessed DM stability within and across populations by looking at correlations of DM versions calibrated using different populations or their demographic subsets. We used regression models to compare these standard DM versions to allostatic load and self-assessed health in their association with diverse health outcomes. Results: DM9 and DM17 were highly stable across population subsets (mean r = 0.96 and 0.95, respectively) and across populations (mean r = 0.94 for both). Performance predicting health outcomes was competitive with allostatic load and self-assessed health, though performance of these markers were somewhat variable for different health outcomes. Conclusions: Both DM9 and DM17 are highly stable within and across populations, supporting their use as objective metrics of health status. DM17 performs slightly better than DM9 and at least as well as other comparable metrics, but requires more biomarkers. The metrics we propose here are easy to measure with data that are available in a wide array of panel, cohort, and clinical studies.

Indirect determination of hematology reference intervals in adult patients on Beckman Coulter UniCell DxH 800 and Abbott CELL-DYN Sapphire devices

2019 ◽  
Vol 57 (5) ◽  
pp. 730-739 ◽  
Author(s):  
Jakob Zierk ◽  
Farhad Arzideh ◽  
Rainer Haeckel ◽  
Manfred Rauh ◽  
Markus Metzler ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Care Center ◽  
Tertiary Care ◽  
Sample Selection ◽  
Reference Intervals ◽  
Red Cell ◽  
Cell Distribution ◽  
Tertiary Care Center ◽  
Test Results ◽  
Distribution Width

Abstract Background Conventional establishment of reference intervals for hematological analytes is challenging due to the need to recruit healthy persons. Indirect methods address this by deriving reference intervals from clinical laboratory databases which contain large datasets of both physiological and pathological test results. Methods We used the “Reference Limit Estimator” (RLE) to establish reference intervals for common hematology analytes in adults aged 18–60 years. One hundred and ninety-five samples from 44,519 patients, measured on two different devices in a tertiary care center were analyzed. We examined the influence of patient cohorts with an increasing proportion of abnormal test results, compared sample selection strategies, explored inter-device differences, and analyzed the stability of reference intervals in simulated datasets with varying overlap of pathological and physiological test results. Results Reference intervals for hemoglobin, hematocrit, red cell count and platelet count remained stable, even if large numbers of pathological samples were included. Reference intervals for red cell indices, red cell distribution width and leukocyte count were sufficiently stable, if patient cohorts with the highest fraction of pathological samples were excluded. In simulated datasets, estimated reference limits shifted, if the pathological dataset contributed more than 15%–20% of total samples and approximated the physiological distribution. Advanced sample selection techniques did not improve the algorithm’s performance. Inter-device differences were small except for red cell distribution width. Conclusions The RLE is well-suited to create reference intervals from clinical laboratory databases even in the challenging setting of a adult tertiary care center. The procedure can be used as a complement for reference interval determination where conventional approaches are limited.

scholarly journals Correlation Between Red Cell Distribution Width and Peripheral Vascular Disease Severity and Complexity

2019 ◽  
Vol 7 (7) ◽  
pp. 77
Author(s):  
Satılmış ◽  
Karabulut
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Clinical Laboratory ◽  
Complete Blood Count ◽  
Clinical Importance ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Peripheral Vascular ◽  
Distribution Width

A traditional hematological marker, red cell distribution width (RDW), is accepted as a novel marker of atherosclerotic vascular diseases. Clinical importance of the RDW as a prognostic biomarker in peripheral vascular disease (PVD) has been reported in a few studies. Herein, we aimed to show the correlation between RDW and PVD severity and its complexity in terms of angiographic evaluation. A total of 118 patients who underwent peripheral lower extremity angiography were subsequently evaluated retrospectively. Upon admission, RDW level was measured with automated complete blood count. Severity and complexity of the PVD was evaluated according to Trans-Atlantic Inter-Society Consensus (TASC II) classification. A TASC II A-B lesion was defined as simple PVD, and a TASC II C-D lesion was defined as prevalent and complex PVD. Then, both groups were compared statistically according to clinical, laboratory, and demographic features, including RDW levels. In 49.6% of the patients, TASC II C-D lesions were observed. Advanced age, male gender, and body mass index (BMI) were associated with TASC II groups. Red cell distribution width levels were correlated with presence of PVD, as well as TASC II grades (p:0.02). The fourth quartile (75th percentile) of the RDW levels was 14.1, and patients with RDW levels ≥14.1 had a more significant correlation with the presence and severity of PVD (p:0.001). In the multivariate regression analysis, elevated RDW was found to be an independent predictor of the presence of PVD and also TASC II C-D lesions (OR:2.26, with a 95% confidence interval (CI) 0.051–0.774; p:0.02). Elevated RDW levels was associated with TASC II C-D lesions, which indicated more prevalent and complex PVD.

scholarly journals Red cell distribution width is a potential predictor of early relapse in polymyalgia rheumatica

Reumatismo ◽  
2021 ◽  
Vol 73 (2) ◽  
pp. 117-121
Author(s):  
D. Soddu ◽  
D. Sola ◽  
M. Bellan ◽  
E. Boin ◽  
M.G. Cittone ◽  
...  
Keyword(s):  
Polymyalgia Rheumatica ◽  
Inflammatory Diseases ◽  
Laboratory Data ◽  
Predictive Marker ◽  
Stepwise Logistic Regression ◽  
Cell Distribution ◽  
Distribution Width ◽  
Early Relapse ◽  
Clinical Records ◽  
Risk Of Relapse

Red blood cell distribution width (RDW) has been studied as a prognostic biomarker for different chronic inflammatory diseases. In this paper we aim to evaluate its potential role in the prediction of early relapse in patients affected by polymyalgia rheumatica (PMR). We revised retrospectively clinical records of patients who received a diagnosis of PMR, according to 2012 ACR/EULAR classification criteria, for whom baseline clinical and laboratory data were available. The baseline RDW variation coefficient was correlated to the risk of relapse, in the first 6 months of the disease. We identified 44 patients [females 15 (34.0%)/males 29 (66.0%); median age 80 (72-83)], 9 of whom had an early relapse. These patients showed a larger median RDW than patients who did not relapse [13.7 (13.5-14.9)% vs 13.5 (12.7-14.2)%; p=0.04). The two groups were comparable for all the other clinical and laboratory parameters considered. Interestingly, patients in the higher half of the RDW distribution showed a shorter relapse-free survival (p<0.03). In a stepwise logistic regression, RDW (p=0.01) predicted the risk of relapse at 6 months, while age, gender, CRP, ESR, Hb, MCV and prednisone dose did not fit the model. Our results show that RDW is an independent biomarker of early relapse, making this parameter a potentially promising predictive marker in PMR.

scholarly journals Biochemical indices to monitor health status with respect to reproductive cycle of Melanochelys trijuga

2013 ◽  
Vol 5 (1) ◽  
pp. 118-124
Author(s):  
Vidya R. Chandavar ◽  
N. Raghu ◽  
R. Lalitha ◽  
Prakash R. Naik
Keyword(s):  
Health Status ◽  
Reproductive Cycle ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Reproductive Period ◽  
Blood Analysis ◽  
Serum Glutamic Pyruvic Transaminase ◽  
Biochemical Profiles ◽  
Biochemical Indices ◽  
Multiple Samples

Blood analysis can provide information regarding the physiological condition of an individual animal or population health as a whole. The present investigation analyzed clinical laboratory data of soluble organic substances of plasma namely triglycerides, cholesterol, HDL, serum glutamic pyruvic transaminase (SGPT/ aspartate amionotransferase) and albumin of Asian pond turtle Melanochelys trijuga. Using multiple samples measures of analysis and variance was determined. M. trijuga exhibited variation in biochemical parameters with respect to reproductive cycle. Biochemical profiles of cholesterol, HDL, LDL, SGPT and albumin values found to be high in preparative period and minimum in recrudescent period of the reproductive cycle. This indicates that the preparative period is the stage where the animals prepare for the forth coming reproductive period. The level of triglycerides and cholesterol varied independently. All the parameters fluctuated with in normal range. The data may be useful to evaluate the health status of the turtle for veterinary care and conservation.

Comparison of Examinees’ and Doctors’ Judgement of Health Status Using Data in an AMHTS

1984 ◽  
Vol 23 (01) ◽  
pp. 15-22
Author(s):  
Y. Sekita ◽  
T. Ohta ◽  
M. Inoue ◽  
H. Takeda
Keyword(s):  
Health Status ◽  
Discriminant Analysis ◽  
Explanatory Power ◽  
Laboratory Data ◽  
Subjective Symptom ◽  
Health Conditions ◽  
Testing System ◽  
Multiple Discriminant Analysis ◽  
Canonical Axis ◽  
Using Data

SummaryJudgements of examinees’ health status by doctors and by the examinees themselves are compared applying multiple discriminant analysis. The doctors’ judgements of the examinees’ health status are studied comparatively using laboratory data and the examinees’ subjective symptom data.This data was obtained in an Automated Multiphasic Health Testing System. We discuss the health conditions which are significant for the judgement of doctors about the examinees. The results show that the explanatory power, when using subjective symptom data, is fair in the case of the doctors’ judgement. We found common variables, such as nervousness, lack of perseverance etc., which form the first canonical axis.

Inflammation and Congenital Heart Disease Associated Pulmonary Hypertension

2015 ◽  
Vol 18 (1) ◽  
pp. 038 ◽  
Author(s):  
Mete Gursoy ◽  
Ece Salihoglu ◽  
Ali Can Hatemi ◽  
A. Faruk Hokenek ◽  
Suleyman Ozkan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cell Distribution ◽  
Inflammation Markers ◽  
Distribution Width ◽  
Artery Pressure ◽  
Lymphocyte Ratio ◽  
Mean Pulmonary Artery Pressure ◽  
Pulmonary Arterial

<strong>Background:</strong> Increased blood flow may trigger pulmonary arterial wall inflammation, which may influence progression of pulmonary artery hypertension in patients with congenital heart disease. In this study, we aimed to investigate the correlation between preoperative inflammation markers and pulmonary arterial hypertension. <br /><strong>Methods:</strong> A total of 201 patients with pulmonary hypertension were enrolled in this study retrospectively; they had undergone open heart surgery between January 2012 and December 2013. Patients’ preoperative C-reactive protein (CRP), neutrophil to lymphocyte ratio, red blood cell distribution width, pulmonary pressures, and postoperative outcomes were evaluated.<br /><strong>Results:</strong> Patient age, neutrophil to lymphocyte ratio, red blood cell distribution width, and CRP were found to be significantly correlated with both preoperative peak and mean pulmonary artery pressures. These data were entered into a linear logistic regression analysis. Patient age, neutrophil to lymphocyte ratio, and CRP were found to be independently correlated with peak pulmonary pressure (P &lt; .001, P &lt; .001, and P = .004) and mean pulmonary artery pressure (P &lt; .001, P &lt; .001, and P = .001), whereas preoperative mean pulmonary artery pressure was found to be independently correlated with intensive care unit stay (P &lt; .001). No parameter was found to be significantly correlated with extubation time and mortality. Eighteen patients had experienced pulmonary hypertensive crisis; in this subgroup, patients’ mean pulmonary artery pressure and neutrophil to lymphocyte ratio were found to be significant (P = .047, P = .003). <br /><strong>Conclusion:</strong> Preoperative inflammation markers may be correlated with the progression of pulmonary hypertensive disease, but further studies with larger sample size are needed to determine the predictive role of these markers for postoperative outcomes.<br /><br />

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