Prognostic value of red cell distribution width and echocardiographic parameters in patients with pulmonary embolism

Introduction: Pulmonary embolism (PTE) is a common cardiovascular emergency. We aimed to predict mortality in the acutephase and to assess the development of pulmonary hypertension in the chronic period with the combined use of red cell distributionwidth (RDW) and echocardiography (ECHO) for the prognosis of PTE. Material and methods: Cases diagnosed with acute PTE were prospectively monitored in our clinic. The initial data of 56 patientswere evaluated. The subjects were separated into two groups basing on RDW; group 1 had RDW ≥ 15.2%, while group 2 hadRDW < 15.2%. Results: Ninety-eight patients were enrolled in the study. We established the sensitivity (73.3%) and the specificity (73.2%) ofRDW to determine mortality in the cases with PTE. RDW ≥ 15.2% value was significant as an independent risk factor for predictingmortality (OR:7.9 95% CI, 1.5–40.9 p = 0.013) in acute PTE. The mean tricuspid annular plane systolic excursion (TAPSE) valuewas significantly different between the group-1 (RDW ≥ 15.2%, 2.20 cm (± 0.43)) and group-2 (RDW < 15.2%, 1.85 cm (±0.53))(p = 0.007). The threshold value for tricuspid jet velocity was > 2.35m/s, the sensitivity and specificity were 76.9% and61.9%, respectively for predicting mortality (AUC: 0.724, 95% CI: 0.591–0.858, p = 0.033). Conclusion: Our results indicate that high RDW levels are an independent predictor of mortality in acute PTE. Lower TAPSElevels show right heart failure in PTE patients; this may also be indicative of right ventricular systolic function. We believe thatdeveloping new scoring systems, including parameters such as RDW, TAPSE, and tricuspid jet velocities, may be effective indetermining the prognosis of pulmonary embolism