Blood Test Can Predict ER and Hospital Outcomes – Hematology

IMAGE: A new study links some CBCs to hospital admissions and risk of hospital death (Photo courtesy of Shutterstock)

IMAGE: A new study links some CBCs to hospital admissions and risk of hospital death (Photo courtesy of Shutterstock)

Red blood cell distribution width (ADGR) is a component of the complete blood count (CBC) panel that measures changes in red blood cell size. Elevated levels of ADGR have been shown to be associated with poorer outcomes in patients with a variety of diseases, from heart disease to COVID-19 pneumonia. Recent studies have identified ADGR as a universal biomarker of emergency department (ED) acuity. However, few studies have explored the prognostic value of ADGR in the ED setting. Previous studies have focused on specific diseases such as acute coronary syndromes, deep vein thrombosis, and sepsis, often using limited sample sizes ranging from hundreds to thousands of patients. Now, a new study using a large dataset of emergency department visits shows that higher ADGR values ​​in the emergency department are associated with admission rates and, for admitted patients, with hospital mortality.

Researchers from the Department of Emergency Medicine at the David Geffen School of Medicine at UCLA (Los Angeles, CA, USA) performed a retrospective analysis of CBC results from more than 200,000 adult emergency department visits between March 2013 and February 2022. The study aimed to investigate the association between baseline ADGR measures obtained during emergency department visits and two key outcomes (hospital admission and in-hospital mortality). Studies have shown that ADGR levels are very frequently elevated at the time of hospital admission. Furthermore, among admitted patients, those who required intensive care unit (ICU) care or experienced in-hospital death showed higher ADGR values.

An ADGR value greater than 16 indicates a specificity of 90% for predicting hospital admission, while an ADGR value greater than 18.5 indicates a specificity of 90% for predicting in-hospital mortality. These findings are consistent with previous studies linking elevated levels of ADGR to an increased risk of death from conditions such as myocardial infarction, pulmonary embolism, heart failure, sepsis, and COVID-19. However, a recent study established the relationship between ADGR and overall hospital admissions and all-cause in-hospital mortality for adult emergency department visits. While boosting ADGR alone may not have the sensitivity needed for a comprehensive diagnostic tool, combining it with other clinical data could greatly improve physicians’ ability to predict hospital admissions and identify patients at higher risk of in-hospital death, the researchers said.

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UCLA David Geffen School of Medicine

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