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dc.contributor.authorOlafsson, Halldor B
dc.contributor.authorSigurdarson, Gissur A
dc.contributor.authorChristopher, Kenneth B
dc.contributor.authorKarason, Sigurbergur
dc.contributor.authorSigurdsson, Gisli H
dc.contributor.authorSigurdsson, Martin I
dc.date.accessioned2020-06-24T10:49:46Z
dc.date.available2020-06-24T10:49:46Z
dc.date.issued2020-03-23
dc.date.submitted2020-06
dc.identifier.citationOlafsson HB, Sigurdarson GA, Christopher KB, Karason S, Sigurdsson GH, Sigurdsson MI. A retrospective cohort study on the association between elevated preoperative red cell distribution width and all-cause mortality after noncardiac surgery. Br J Anaesth. 2020;124(6):718-725. doi:10.1016/j.bja.2020.02.009en_US
dc.identifier.pmid32216958
dc.identifier.doi10.1016/j.bja.2020.02.009
dc.identifier.urihttp://hdl.handle.net/2336/621456
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractBackground: Elevated red cell distribution width (RDW) has been associated with worse outcomes in several medical patient populations. The aim of this study was to investigate the association of increased preoperative RDW and short- and long-term mortality after noncardiac surgery. Methods: This investigation was a retrospective cohort study including all patients undergoing noncardiac surgery between 2005 and 2015 at Landspitali-the National University Hospital in Iceland. Patients were separated into five predefined groups based on preoperative RDW (≤13.3%, 13.4-14.0%, 14.1-14.7%, 14.8-15.8%, and >15.8%). The primary outcome was all-cause long-term mortality and secondary outcomes included 30-day mortality, length of stay, and readmissions within 30 days, compared with propensity score matched (PSM) cohort from patients with RDW ≤13.3%. Results: There was a higher hazard of long-term mortality for patients with RDW between 14.8% and 15.8% (hazard ratio=1.33; 95% confidence interval, 1.15-1.59; P<0.001) and above 15.8% (hazard ratio=1.66; 95% confidence interval, 1.41-1.95; P<0.001), compared with matched controls with RDW ≤13.3%. This association held in multiple patient subgroups. For secondary outcomes, there was no difference in 30-day mortality, length of stay, or risk of readmission within 30 days. Conclusions: Increased preoperative RDW is associated with increased long-term mortality after noncardiac surgery. RDW could be a composite biomarker of pre-existing chronic inflammation and poor nutritional status. Future studies should clarify if this is a modifiable risk factor for improved surgical outcomes. Keywords: inflammation; mortality; noncardiac surgery; perioperative outcome; propensity score matching; red cell distribution width.en_US
dc.description.sponsorshipLandspitali University Hospital Science Fund Icelandic Student Innovation Funden_US
dc.language.isoenen_US
dc.publisherElsevier Scienceen_US
dc.relation.urlhttps://www.sciencedirect.com/science/article/pii/S0007091220301008en_US
dc.rightsCopyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
dc.subjectinflammationen_US
dc.subjectmortalityen_US
dc.subjectnoncardiac surgeryen_US
dc.subjectperioperative outcomeen_US
dc.subjectpropensity score matchingen_US
dc.subjectred cell distribution widthen_US
dc.subjectBlóðkornen_US
dc.subjectHjartalækningaren_US
dc.subjectLífslíkuren_US
dc.subject.meshErythrocyte Indicesen_US
dc.titleA retrospective cohort study on the association between elevated preoperative red cell distribution width and all-cause mortality after noncardiac surgery.en_US
dc.typeArticleen_US
dc.identifier.eissn1471-6771
dc.contributor.department1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 3Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Division of Anaesthesia and Intensive Care Medicine, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland. 4Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Division of Anaesthesia and Intensive Care Medicine, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland. Electronic address: martiningi@gmail.com.en_US
dc.identifier.journalBritish journal of anaesthesiaen_US
dc.rights.accessOpen Access - Opinn aðganguren_US
dc.departmentcodeAAA12
dc.source.journaltitleBritish journal of anaesthesia
dc.source.volume124
dc.source.issue6
dc.source.beginpage718
dc.source.endpage725
dc.source.countryEngland


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