COPD: performance of red cell distribution width in predicting exacerbation severity

<bold>Background:</bold> The progression of chronic obstructive pulmonary disease (COPD) can be marked by severe exacerbations that may threaten the patient's life prognosis. Several inflammation markers have shown their importance in predicting the severity of exacerbations; is this the case for Red Cell Distribution Width (RDW)? <bold>Aims:</bold> Evaluate the performance of RDW in predicting the severity of COPD exacerbations. <bold>Methods:</bold> This was a prospective study collecting data from patients with COPD in the pneumology department, Charles Nicolle Hospital, Tunis, from December 2017 to December 2021. These patients were followed for one year. A severe exacerbation was defined as an exacerbation requiring hospitalization. <bold>Results:</bold> A total of 200 patients were included, with a mean age of 64.02±12 years. A male predominance was noted (89%). At least, one comorbidity was found in 68% of cases. The majority of patients (78.5%) were classified in Group E. In 88.5% of patients, at least one exacerbation was recorded, of which 35.5% were severe. The average RDW level was estimated at 14.2±3.27%. The Area Under the Curve for RDW to predict a severe exacerbation was 0.748 [0.669-0.827], 95% CI, p<0.001. The optimal RDW cutoff was 13.9%, with a sensitivity of 76.8% and specificity of 71.3%. <bold>Conclusions:</bold> The RDW level, a simple biological parameter, appears to be a useful tool for anticipating the occurrence of severe exacerbations, allowing early identification of this high-risk population.