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Innere Medizin 3. Februar 2015

Red cell distribution width: a novel prognostic factor of pulmonary embolism?

In a recent issue of “Wiener klinische Wochenschrift” “The Central European Journal of Medicine,” we read the article by Sen et al. with great interest. In this well presented article, the authors aimed to assess prognostic value of complete blood cell count, renal function markers, C-reactive protein, and simplified pulmonary embolism severity index (sPESI) scoring system in pulmonary embolism (PE) 100-day mortality. They concluded that red cell distribution width (RDW) and sPESI were found to be statistically significant predictors of PE mortality. Being inexpensiveness and currently easy availability of RDW parameter may encourage its usefulness in daily practice in the near future. We would like to thank to the authors for their contribution.

RDW, which is used in the differential diagnosis of anemia, is an automated measure of the variability of red blood cell size in complete blood cell count. Previous studies have demonstrated that RDW is an independent variable of prognosis in patients with cardiovascular diseases such as heart failure, myocardial infarction, stroke, and pulmonary hypertension. Furthermore, it was also found to be related to mortality and other severe adverse outcomes in renal and infectious diseases. Chronic inflammation, bone marrow depression, aging, malnutrition, iron, or vitamin B12 deficiency, and any medication may affect RDW levels. Thus, it would have been useful, if the authors had mentioned these RDW-affecting factors.


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