High « red cell distribution width » levels can predict pulmonary embolism risk in multiple trauma patients: a case control study.

Background: Several studies have found a relationship between a high level of « distribution width of red blood cells » (RDW) and the risk of thromboembolic conditions in medical fields. The aim of this study is to evaluate the association between high levels of RDW and pulmonary embolism risk in multiple trauma patients. Methods: It is a case control study, conducted in a tunisian department of anesthesia and intensive care. Multiple trauma patients with pulmonary embolism over a 3 years period were enrolled in the « case group ». Control group included patients matched to the « case group » according to demographic characterictic and injury severity. RDW levels were compared between both groups. A high RDW level was defined by a threshold of 14.5%. Resultats: During the study period, 50 patients were enrolled in each group. Both groups were comparable according to demographic characteristics and injury severity. Average RDW levels were 15.7 in case group and 11.88 in control group. For all patients, pulmonary embolism was diagnosed by chest CT angiography. Pulmonary embolism was 4 times more frequent in patients with high RDW levels (OR 4.58). Hospital length of stay and mortality were higher in “case group” without significant differences. Conclusion: High RDW levels seem to be associated to a higher risk of pulmonary embolism in multiple trauma patients. Early preventive anticoagulation and non pharmacological measures should be used in patients with increased RDW levels.