Clinical importance of red cell distribution width and red cell index in pulmonary embolism.

OBJECTIVE: Discrimination of high mortality risk pulmonary embolism (PE) patients at the first admission to the hospital is important for the follow-up and the clinical progress of patients. Additional biomarkers are needed for the initial assessment. The aim of this study was to investigate whether red cell distribution width (RDW) and red cell index (RCI) were associated with 30-day mortality risk and mortality rate in PE patients. PATIENTS AND METHODS: 101 PE patients and 92 non-PE patients were included in the study. PE patients were divided into three groups according to 30-day mortality risk. The correlations of RDW and RCI with PE, 30-day mortality risk and mortality rates were determined. RESULTS: RDW value was significantly higher in the PE group than in the non-PE group (15.0 % vs. 14.3%, respectively, p=0.016). The cut-off value of RDW to discriminate PE from the non-PE group was 14.55% (sensitivity: 45.7%; specificity: 55.5%, p=0.016). There was a significant correlation between RDW values and mortality rates (R2= 0.11, p=0.001). The cut-off value of RDW in mortality of PE was 15.05% (sensitivity: 40.6%, specificity: 31.2%, p=0.001). On the other hand, simultaneously measured RCI values were similar between PE and non-PE groups. There wasn't any significant difference in RCI values between 30 day-mortality risk groups. No correlation was found between RCI and the mortality due to PE. CONCLUSIONS: To the best of our knowledge, this is the first report in the literature to simultaneously investigate RDW and RCI values for their association with 30-day mortality risk and mortality rates in pulmonary embolism (PE) patients. Our findings suggest that RDW values may serve as a new early predictor, while RCI values were not predictive.

Comparison of thiol/disulphide homeostasis parameters in patients with COPD, asthma and ACOS.

OBJECTIVE: Chronic obstructive pulmonary disease (COPD), asthma and asthma-COPD overlap syndrome (ACOS) are obstructive pulmonary disorders with different manifestations. Status of oxidation in tissues is important in obstructive pulmonary disorders. Smoking, acute exacerbations of COPD and asthma were associated with a marked imbalance in oxidant or antioxidant status due to increased oxidative stress in tissues and blood. Oxidative conditions may cause a reversible formation of mixed disulphides among protein thiol groups. The aim of this study was to compare parameters related with thiol/disulphide homeostasis in patients with COPD, asthma and ACOS. PATIENTS AND METHODS: Patients (n= 135, 69 females, 66 males) who were referred with a diagnosis of COPD, asthma or ACOS were included in the study. Thiol/ disulphide homeostasis parameters in blood were analysed by a newly established method that measures the exact thiol/ disulphide status in the body. RESULTS: The patients with COPD, asthma or ACOS were similar for demographic parameters other than age and number of cigarettes smoked. Measured thiol/disulphide homeostasis parameters were similar among these patient groups. When these biochemical measurements were adjusted for age and number of cigarettes by using regression analysis, similarity for thiol/disulphide homeostasis parameters among patient groups persisted. CONCLUSIONS: To best of our knowledge, this is the first study to compare thiol/disulphide homeostasis parameters in COPD, asthma and ACOS patients. Similarity of thiol/disulphide homeostasis parameters among these patient groups supports the current view of Dutch hypothesis that COPD, asthma and ACOS share similar pathophysiological features but display different clinical manifestations.