Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251401576. doi: 10.1177/10760296251401576. Epub 2025 Nov 27.
ABSTRACT
BackgroundAlthough red cell distribution width (RDW) has been linked to venous thromboembolism, its predictive value for postoperative pulmonary embolism (PE) in surgical trauma patients remains ambiguous. This study aimed to investigate the correlation between preoperative RDW and postoperative PE risk.MethodsWe incorporated 46506 surgical trauma patients from three medical institutions and the MIMIC-IV 2.2 database. We constructed receiver operating characteristic curves (ROC) utilizing preoperative (at admission) RDW and postoperative PE and classified patients into two groups. Firstly, univariate logistic regression was conducted to identify factors correlated with postoperative PE, and the variance inflation factor was computed to evaluate multicollinearity. Multivariate logistic regression analysis was subsequently conducted to identify the independent risk factors for PE. Propensity score matching (PSM) was conducted using a caliper value of 0.1, balancing 26 covariates between the two groups, including demographic features, vital signs, injury severity scores, comorbidities, and laboratory parameters. A total of 10235 pairs were successfully matched.ResultsThe postoperative PE incidence was 0.56%. RDW showed significant predictive value for PE with an area under the curve (AUC) of 0.723 (0.696-0.750). Before PSM, RDW ≥14.4% was associated with increased PE risk (OR 4.70, 95% CI 3.63-6.09, P < 0.001). Multivariate analysis confirmed a 1.90-fold risk increase (95% CI 1.42-2.55, P < 0.001). After PSM, RDW ≥14.4% remained significantly associated with higher PE risk (OR 1.67, 95% CI 1.22-2.29, P = 0.002).ConclusionElevated preoperative RDW is an independent risk factor for postoperative PE in trauma patients, with ≥14.4% indicating significantly increased risk.
PMID:41308029 | DOI:10.1177/10760296251401576