Clinical Utility of Red Blood Cell Distribution Width Parameter in Patients with Hemodynamically Stable Acute Pulmonary Embolism

Objective: Patients with acute pulmonary embolism (PE) presenting with persistent hypotension or shock are considered to be high-risk, while hemodynamically stable patients with acute PE are classified as low- or moderate-risk, depending on their right ventricular dysfunction and/or levels of biomarkers indicating myocardial injury. In this study, we assessed the clinical benefits of knowing the red cell distribution width (RDW) parameter in patients with hemodynamically stable acute PE.
Methods: All patients diagnosed with acute PE in our hospital between 2008 and 2010 were retrospectively included in the study. Patients with hypotension, a history of malignancy, heart failure, and/or anemia were excluded. Patients with normotensive acute PE were divided into either a low- or moderate-risk group. This classification was made according to echocardiographic right ventricular dysfunction, positive troponin T, and the level of NT-proBNP. RDW values of low and moderate acute PE risk groups were compared.
Results: Thirty-two patients were assessed as moderate-risk and 34 patients were low-risk PE. RDW values of the moderate-risk group were significantly higher than those of the low-risk group (14.77±0.54 vs. 14.09±0.43; p=0.036, respectively).
Conclusion: Analysis of RDW values can help to determine the low and moderate risk levels of hemodynamically stable patients with acute PE.