Red Blood Cell Distribution Width: A Novel Predictor of Mortality Following Amputation in Diabetic Foot

Abstract

Category: Diabetes Introduction/Purpose: Red blood cell distribution width (RDW), reflects the degree of heterogeneity of erythrocyte volume, has been found to be a significant prognostic factor in various human disorders. Herein, we assessed the value of RDW as a prognostic factor in diabetic foot amputation. Methods: Data of 415 patients with diabetic foot underwent amputation between January 2009 and January 2019 were analyzed retrospectively. After establishing a cut-off point of preoperative RDW for all-cause mortality, Cox proportional hazard model for mortality and logistic regression analysis for length of hospital stay more than 1 month were performed with other variable Results: RDW >14.5% was a significant risk factor for mortality (hazard ratio, 2.55; 95% confidence interval [CI], 1.55 to 4.19) on multivariable-adjusted regression analysis. Other significant factors associated with mortality were age and kidney disease. High RDW was also associated with longer hospitalization over 30 days (odds ratio, 2.17; 95% CI, 1.29 -3.66). Conclusion: High preoperative RDW over 14.5% is an independent prognostic factor with increased mortality and longer hospitalization, implying that RDW may be a simple and inexpensive laboratory parameter for risk stratification in diabetic foot amputation.