Upper GI bleed prognostication with RDW

  • PLoS One

  • Jenny Blair, MD
  • Clinical Essentials
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • Higher red-cell distribution width (RDW; ≥14.5%) is associated with high-risk upper gastrointestinal bleeding (UGIB) and may aid in emergent risk stratification.

Why this matters

  • UGIB carries 6%-13% mortality risk, and early risk stratification can be challenging.

  • RDW, a quick and inexpensive measure, has been linked to major bleeding in several forms of critical illness and injury.

Key results

  • 229 participants (63.6%) were at high-risk.

  • High-risk patients had higher RDW (15.7 vs 13.9; P<.001>

  • Higher RDW quartiles were associated with high-risk UGIB:

—second-highest quartile vs lowest: OR, 3.144; 95% CI, 1.250-7.905;

—highest quartile vs lowest: OR, 4.182; 95% CI, 1.483-11.790.

  • RDW alone did not outperform Glasgow Blatchford Score for predicting high-risk UGIB.

Study design

  • Retrospective observational study of 360 consecutive adults diagnosed with UGIB in a single emergency department (ED).

  • Patients were classified as high- vs low-risk based on the need for emergent intervention or serious complications.

  • Researchers performed multivariate logistic regression analysis to determine high-risk variables.

  • Funding: Konkuk University, South Korea.

Limitations

  • Small single-center retrospective study of an ED population.

  • Population had higher incidence of high-risk UGIB than in other studies because of ethnicity, according to authors.