No definitive prognostic biomarkers for carbon monoxide (CO) poisoning have been proposed. The aim of this study is to investigate, through a systematic literature review and pooled analysis, whether red blood cell distribution width (RDW) can predict disease severity in CO-poisoned patients. We performed an electronic search in Scopus and PubMed using the keywords: \'red blood cell distribution width\' OR \'RDW\' AND \'carbon monoxide\' AND \'poisoning,\' with no time or language restrictions (i.e. through August 2023) to find clinical studies that examined the value of RDW in patients with varying severity of CO poisoning. The analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting checklist. We identified 29 articles, seven of which were included in our analysis, with a total of 1979 CO-poisoned patients, 25.9% of whom were severely ill. In all but one of the studies, the RWD mean or median value was higher in CO-poisoned patients with severe disease. The weighted mean difference (WMD) of RDW was 0.36 (95% confidence interval (CI), 0.26-0.47)%. In the three articles in which the severity of illness in CO-poisoned patients was defined as cardiac injury, the WMD of the RDW was 1.26 (95%CI, 1.02-1.50)%. These results suggest that monitoring RDW in CO-poisoned patients may help to determine the severity of disease, particularly cardiac injury.

OBJECTIVE: Mitral valve surgery in children involves correcting congenital and acquired pathologies, with a reported mortality rate of 0.9%. Low cardiac output syndrome (LCOS) is a serious complication with the incidence of 20-25%. The aim of the study was to estimate possible prognostic factors of LCOS in children undergoing mitral valve procedure.
METHODS: This single-center retrospective analysis enrolled children aged <18 years who underwent mitral valve surgery during 24 year period. Preoperative clinical and laboratory parameters, and operative factors were analyzed.
RESULTS: Thirty consecutive pediatric patients (11 (37%) males and 19 (63%) females) in median (Q1 - Q3) age of 57 (25-115) months, who underwent mitral valve replacement, were included. The 30-day mortality was 7% (2 patients) and was related to postoperative multiorgan failure. LCOS occurred in 8 (27%) children. The receiver operator curve (ROC) analysis established parameters that have predictive value for LCOS occurrence: cardiopulmonary bypass (CPB) time, with 89 ​min as optimal cut-off point (AUC ​= ​0.744, p ​= ​0.011) yielding sensitivity of 100% and specificity of 42.9%; left ventricular ejection fraction (LVEF) ​< ​60 % (AUC ​= ​0.824, okp ​= ​0.001) with sensitivity of 62.5% and specificity of 93.75%; and red blood cell distribution width (RDW) above 14.5 % (AUC ​= ​0.840, p ​< ​0.001; sensitivity of 87.5% and specificity of 75%).
CONCLUSIONS: In mitral valve replacement in pediatric patients, CPBtime above 89 ​min, preoperative LVEF below 60% and preoperative RDW above 14.5% can be regarded as the potential predictors of LCOS.

Diseases of the aorta, such as aortic aneurysm, dissection, and rupture, account for a large proportion of acute clinical emergencies. The red blood cell distribution width (RDW), which directly reflects anisocytosis (i.e., the heterogeneity of erythrocyte volumes), has emerged as a promising biomarker for many cardiovascular pathologies. Thus, we aimed to explore the implication of RDW in aortic pathologies. We searched Scopus and PubMed using the keywords \"RDW\" OR \"red blood cell distribution width\" AND \"aortic aneurysm\" OR \"aortic dilatation\" OR \"aortic dissection\" for identifying studies in which RDW values were measured in patients with these aortic diseases. Ten observational studies were finally included. In all studies, RDW value was increased in patients with aortic diseases. In the four studies in which sufficient RDW data were available for pooling, the weighted mean difference (WMD) of RDW in patients with or without complicated aortic pathologies was 0.575 (95 %CI, 0.254-0.896). RDW may be a valuable diagnostic and prognostic biomarker in patients with aortic pathologies.

Dietary cadmium (Cd2+) intake is implicated in the pathogenesis of hypertension and anaemia, but there is a paucity of information on the haematological changes in hypertensive conditions. This study, therefore, aims to evaluate the effects of Cd2+ on blood pressure (BP) and haematological indices in the Sprague-Dawley rat model. Three cohorts (n = 10 each) of control and Cd2+-fed male Sprague-Dawley rats were selected. Cd2+-exposed rats received 2.5 or 5 mg/kg b.w. cadmium chloride via gavage thrice-weekly for eight weeks, while control animals received tap water. BP and flow were measured non-invasively from rat tails twice-weekly using a CODA machine, while weights were measured thrice-weekly. Haematological indices were assessed using the Cell-Dyn Emerald Haematology Analyzer. Data were reported as mean ± SEM, and statistically analyzed using One-Way Analysis of Variance. Bonferroni post hoc test was used for multiple comparisons. Cd2+-exposure induced hypertension by significantly (p < 0.05) elevating systolic, diastolic, and mean arterial BPs, pulse pressure, and heart rate (HR), and increased (p < 0.05) blood flow. Mean cell volume (MCV) and haemoglobin (MCH) were significantly (p < 0.05) reduced, and red cell distribution width (RDW) significantly (p < 0.01) increased by exposure to 5 mg/kg b.w. Cd2+. Haemoglobin concentration (MCHC), haematocrit, haemoglobin, red blood cell, platelet, mean platelet volume, and white blood cell counts were unaffected by Cd2+-exposure. Cd2+ induced hypertension, microcytosis, hypochromicity, and anisocytosis without anaemia, which may be precursor to microcytic anaemia and coronary artery disease. This study is important in Cd2+-exposed environments and warrants further investigations.

UNASSIGNED: This systematic literature review and meta-analysis investigated whether the red blood cell distribution (RDW) may predict survival outcomes in laryngeal cancer patients undergoing curative treatment.
UNASSIGNED: We conducted an electronic search in Medline and Scopus using the keywords \"red blood cell distribution width\" OR \"RDW\" AND \"laryngeal cancer\" OR \"larynx cancer\" OR \"laryngeal carcinoma\" OR \"larynx carcinoma,\" without time or language restrictions (up to February 2023), for identifying studies investigating the prognostic value of RDW in patients with any form of laryngeal cancer and with a primary endpoint that was set as survival rate and/or disease-free survival between 1 and 10 years after curative treatment. The research was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting checklist.
UNASSIGNED: Izvršili smo elektronsku pretragu u Medline i Scopusu koriste}i ključne reći \"širina distribucije crvenih krvnih zrnaca\" ILI \"RDW\" I \"rak larinksa\" ILI \"karcinom larinksa\" ILI \"karcinom larinksa\" ILI \"karcinom larinksa\", bez vremenskih ili jezičkih ograničenja (do februara 2022. godine), za identifikaciju prognostičkih vrednosti RDW u pacijenata sa bilo kojim oblikom laringealnog kancera i sa primarnom krajnjom tačkom koja je postavljena kao stopa preživljavanja i/ili preživljavanje bez bolesti izme|u 1 i 10 godina nakon kurativnog lečenja. Istraživanje je sprovedeno prema PRISMA (Preferred Reporting Items for Sistematic Revievs and Meta-Analises) kontrolnoj listi za izveštavanje za 2020. godinu.
UNASSIGNED: Digitalna pretraga nam je omogućila da identifikujemo pet studija koje su konačno uključene u na{u objedinjenu analizu (stopa preživljavanja i/ili preživljavanje bez bolesti pokrivali su period izmđu 2,7-8,3 godine). U četiri od pet studija, povećana vrednost RDW kod pacijenata sa karcinomom larinksa koji su bili podvrgnuti hirurškom tretmanu ili tretmanu zračenjem bila je povezana sa lošijim preživljavanjem (opseg odnosa šanse ORs, 2,28-10,44). U objedinjenoj analizi, povećani RDW je dao preko 3 puta veći rizik od umiranja tokom praćenja nakon kurativnog lečenja karcinoma larinksa (OR, 3,37; 95% CI, 1,41-8,10).
UNASSIGNED: RDW zadržava klinički važnu prognostičku vrednost kod pacijenata sa karcinomom larinksa koji su podvrgnuti kurativnom lečenju. Kliničari bi mogli da priznaju ove informacije za korišćenje agresivnije terapije ili postavljanje užeg praćenja kod pacijenata sa rakom larinksa sa povećanim vrednostima RDW.

The advent of immune checkpoint inhibitors (ICIs) has revolutionized the metastatic renal cell carcinoma (mRCC) therapeutic landscape. Nevertheless, tyrosine-kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) axis still play a key role. The aim of the present study was to explore the prognostic performance of an integrated blood score, based on hemoglobin (Hb) concentration, mean corpuscular volume (MCV), and red cell distribution width (RDW), in mRCC patients treated with anti-VEGF TKIs. The primary endpoint was to correlate Hb, MCV, and RDW with progression-free survival (PFS) and overall survival (OS).
Our multicenter retrospective observational study involved mRCC patients treated with pazopanib or cabozantinib from January 2012 to December 2020 in nine Italian centers. Clinical records and laboratory data, including Hb levels, MCV, and RDW, were collected at baseline. Descriptive statistics and univariate and multivariate analyses were performed.
We enrolled 301 mRCC patients of which 179 (59%) underwent pazopanib, and 122 (41%) cabozantinib. We considered baseline Hb ≥12 g/dL, MCV >87 fL, and RDW ≤16% as good prognostic factors; hence, developing a multiparametric score capable of delineating 4 different categories. The number of good prognostic factors was associated with significantly longer PFS and OS (p < 0.001 for both). Therefore, we developed a red blood cell-based score by stratifying cases into two groups (2-3 versus 0-1, good factors). The impact on PFS and OS was even more striking (median PFS (mPFS): 16.3 vs 7.9 months; median OS (mOS): 33.7 vs 14.1 months)), regardless of the TKI agent. When challenged with univariate and multivariate analysis, the blood score maintained its high prognostic significance in terms of OS (multivariate analysis HR for OS: 0.53, 95% CI 0.39-0.75; p < 0.001, respectively), while the impact on PFS resulted in borderline significance.
Our analyses demonstrate the prognostic role of a multiparametric score based on easily exploitable blood parameters, such as Hb concentration, MCV, and RDW. The red blood cell-based score may underlie the upregulation of the HIF-1α pathway and VEGF axis, thereby identifying a selected population who is likely to benefit from TKI therapy.

UNASSIGNED: This study aims to evaluate the consistency of heterogeneity degree of erythrocyte volume parameters between the blood automated analyzer Sysmex-XN9000 and the advanced red blood cell software CellaVisionDI-60.
UNASSIGNED: 500 blood samples of volunteers were analyzed by Sysmex-XN9000 and CellaVision-DI60. The sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, and false negative rate were evaluated. The consistency of all parameters was tested.
UNASSIGNED: Taking the standard RBC group as the control group, the RBC parameters of the macrocytic and the microcytic group were compared. There was a statistical difference between the groups. ROC curve analysis showed that the best cutoff value of microcytic and of macrocytic affecting MCV were 4.1% and 5.7%, respectively. The best cutoff value of anisocytosis was 15.0%. The correlation coefficient between anisocytosis and red blood cell distribution width (RDW-CV) was 0.756. The sensitivity, specificity, positive predictive value and coincidence rate of anisocytosis were high. The false negative rate was 10.0%, and the false positive rate was 7.4%.
UNASSIGNED: All parameters of the degree of heterogeneity have good accuracy and consistency in the two instruments. Anisocytosis is with higher coincidence rate and positive predictive value. MIC and MAC have a good prediction on the increase or decrease of MCV. Although advanced RBC software\'s false negative and false positive rates are high, the red blood cell image system is more intuitive and time-saving in observing cells. Consequently, CellaVision-DI60 is suggested to combine with XN-9000 for judging the anisocytosis in daily work comprehensively.

UNASSIGNED: Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes.
UNASSIGNED: We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed.
UNASSIGNED: The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).
UNASSIGNED: A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients.
UNASSIGNED: mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs.

The search for affordable and accurate predictors of the outcome of COVID-19 is extremely important, as it provides the possibility to effectively correct the patient treatment tactics.
To develop simple and accurate criteria based on the dynamics of red blood counts that predict the outcome of COVID-19.
Observations were carried out in 125 patients with severe and extremely severe COVID-19, in whom indicators characterizing the state of red blood were determined in dynamics on days 1, 5, 7, 10, 14 and 21 after the hospitalization. ROC analysis was performed to calculate the threshold predictive values for survival and mortality.
The total number of erythrocytes and the level of hemoglobin in severe and extremely severe patients did not go beyond the acceptable limits, although showed a tendency to decrease in the group of fatal cases. On the 1st and 21st days, the number of MacroR in the deceased patients was reduced compared to those in group of survivors. It has been established that the RDW-CV test can predict the outcome of the COVID-19 with a high degree of probability at a relatively early stage of disease. RDW-SD test can be an additional predictive criterion of COVID-19 outcome.
The RDW-CV test can be used as an effective predictor of disease outcome in patients with severe COVID-19.
Введение. Поиск доступных и точных предикторов исхода COVID-19 имеет крайне важное значение, так как позволяет эффективно корригировать тактику лечения пациента. Цель работы на основе динамики показателей красной крови разработать простые и точные критерии, предсказывающие исход COVID-19. Материалы и методы. Наблюдения проведены у 125 пациентов с тяжёлым и крайне тяжёлым течением COVID-19, у которых на 1, 5, 7, 10, 14 и 21-й день пребывания в стационаре в динамике определялись показатели, характеризующие состояние красной крови. Для расчёта пороговых значений выживаемости и летальности, имеющих предиктивную ценность, проводился ROC-анализ. Результаты. Общее число эритроцитов и уровень гемоглобина у тяжелобольных и крайне тяжелобольных не выходили за пределы допустимых норм, хотя в группе умерших на всём протяжении исследования проявляли тенденцию к уменьшению. В 1-й и 21-й день количество MacroR у умерших по сравнению с выжившими было сниженным. Установлено, что по показателю RDW-CV с большой долей вероятности на относительно ранних сроках можно судить об исходе заболевания COVID-19. Дополнительным критерием исхода COVID-19 может служить показатель RDW-SD. Заключение. Показатели RDW-CV и RDW-SD при тяжёлом течении COVID-19 могут быть использованы как эффективные предикторы исхода заболевания.

Inflammation and immune dysregulation have been associated with adverse outcomes in cardiovascular disease. There is limited understanding of the association of different profiles of white blood cell (WBC) subsets and red cell distribution width (RDW) in patients with chronic limb-threatening ischemia (CLTI).
Patients with CLTI undergoing endovascular revascularization in our single-center, tertiary care hospital from 2017 to 2019, who had a preceding complete blood count (CBC) with WBC differentials (n =213), were included in the analysis. Patient characteristics, laboratory values, and clinical outcomes were collected. Cox proportional hazards regression models were used to assess for associations between all-cause mortality and leukocyte subset; multivariate analysis was used to account for confounders. Kaplan-Meier curves were generated to depict survival censored at 1 year postrevascularization using baseline CBC indices.
Adjusting for confounders, elevated RDW was associated with increased mortality (continuous per % increase, adjusted hazard ratio [HR] 1.33, p < 0.001). Baseline lymphopenia was associated with mortality in univariate analysis. Other leukocyte subtypes were not associated with mortality outcomes in our population. Exploratory analysis showed negative deflections in ∆WBC from pre- to postprocedure day 1 were affiliated with increased mortality when adjusted for age, sex, race, chronic kidney disease, and baseline hemoglobin (∆WBC HR 1.16, p = 0.004). Further exploratory analysis showed an association between RDW and all-comers readmission.
The utilization of a periprocedural WBC subset differential can be a useful adjunct to risk-stratify patients with CLTI undergoing endovascular revascularization. Further studies are needed to understand potential ways to modulate immune dysregulation so as to improve mortality outcomes.