Red cell distribution width as a predictor multiple organ dysfunction syndrome in patients undergoing heart valve surgery

Abstract

PURPOSE The aim of the study was to evaluate the prognostic value of RDW for multiple organ dysfunction syndrome (MODS) in the early postoperative period in patients undergoing valve replacement or repair surgery. METHODS A prospective study was conducted on a group of 713 consecutive patients with haemodynamically significant valvular heart disease who underwent elective valvular surgery. The primary end-point at the 30-day follow-up was postoperative MODS. The secondary end-point was death from all causes in patients with MODS. RESULTS The postoperative MODS occurred in 72 patients. At multivariate analysis: RDW (OR 1.267; 95% CI 1.113-1.441; p=0.0003), creatinine (OR 1.007; 95% CI 1.001-1.013; p=0.02) and age (OR 1.047; 95% CI 1.019-1.077; p=0.001) remained independent predictors of the primary end-point. Receiver operator characteristics analysis determined a cut-off value of RDW for the prediction of the occurrence of the perioperative MODS at 14.3%. RDW (OR 1.448; 95% CI 1.057-1.984; p=0.02) and age (OR 1.057; 95% CI 1.007-1.117; p=0.04) were associated with an increased risk of death in patients with perioperative MODS. CONCLUSIONS Elevated RDW is associated with a higher risk of MODS and death in patients with MODS following heart valve surgery.