Red cell distribution width predicts mortality in infective endocarditis

Abstract

Background. - Infective endocarditis (IE) is associated with significant morbidity and mortality. Red cell distribution width (RDW) is a recently recognized biomarker of adverse outcome in a number of acute and chronic conditions. Aim. - To investigate the relationship between RDW and 1-year survival in patients with IE. Methods. - Clinical records from two tertiary centres were used to analyze data from patients with definite IE. Clinical, echocardiographic and biochemical variables were evaluated along with RDW. One-year survival status after index hospitalization was identified for each patient. Results. - One hundred consecutive patients (mean age 47.8 +/- 16.7 years; 61% men) with definite IE were enrolled. According to receiver operating characteristic curve analysis, the optimal RDW cut-off value for predicting mortality was 15.3% (area under the curve 0.70; P=0.001). Forty-one patients (41%) died within 1 year; of these, 88% had ROW results > 15.3%. Univariate Cox proportional-hazards analysis showed that RDW > 15.3%, heart failure, renal failure, cardiac abscess, severe valvular regurgitation and presence of dehiscence were associated with increased mortality. Multivariable Cox proportional-hazards analysis revealed that renal failure (hazard ratio [HR] 3.21, 95% confidence interval [CI] 1.35-7.59; P = 0.008), heart failure (HR 2.77, 95% CI 1.1-6.97; P = 0.03) and RDW > 15.3% (HR 3.07, 95% CI 1.06-8.86; P = 0.03) were independent predictors of mortality in patients with IE. Conclusion. - According to our results, mortality is high in patients with IE. RDW is a promising biomarker for predicting 1-year survival rates in these patients. (C) 2014 Published by Elsevier Masson SAS.