Predictive value of red blood cell distribution width and hematocrit for short-term outcomes and prognosis in colorectal cancer patients undergoing radical surgery

doi:10.3748/wjg.v30.i12.1714

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Mar 28, 2024; 30(12): 1714-1726
Published online Mar 28, 2024. doi: 10.3748/wjg.v30.i12.1714

Table 1 Comparison between the higher red blood cell distribution width group and the lower red blood cell distribution width group

Characteristics	Higher RDW (n = 1573)	Lower RDW (n = 2685)	P value
RDW	17.3 ± 3.3	13.0 ± 0.6	< 0.01^a
Age, yr	64.1 ± 12.8	62.2 ± 11.7	< 0.01^a
Sex			< 0.01^a
Male	873 (55.5)	1640 (61.1)
Female	700 (44.5)	1045 (38.9)
BMI, kg/m²	22.3 ± 3.3	22.9 ± 3.1	< 0.01^a
Smoking	570 (36.2)	1047 (39.0)	0.074
Drinking	434 (27.6)	881 (32.8)	< 0.01^a
Hypertension	434 (27.6)	679 (25.3)	0.099
T2DM	222 (14.1)	319 (11.9)	0.035^a
CHD	90 (5.7)	91 (3.4)	< 0.01^a
Open surgery	281 (17.9)	282 (10.5)	< 0.01^a
Tumor location			< 0.01^a
Colon	940 (59.8)	1068 (39.8)
Rectum	633 (40.2)	1617 (60.2)
TNM stage			< 0.01^a
I	218 (13.9)	585 (21.8)
II	727 (46.2)	1020 (38.0)
III	538 (34.2)	976 (36.4)
IV	90 (5.7)	104 (3.8)
Tumor size			< 0.01^a
< 5 cm	739 (47.0)	1716 (63.9)
≥ 5 cm	834 (53.0)	969 (36.1)
Operation time (min)	230.3 ± 81.9	225.8 ± 84.1	0.087
Blood loss (mL)	116.4 ± 171.8	93.3 ± 131.0	< 0.01^a
Hospital stay (d)	11.5 ± 7.7	11.2 ± 9.2	0.283
Overall complications	400 (25.4)	538 (20.0)	< 0.01^a
Major complications	42 (2.7)	60 (2.2)	0.370

^aP value < 0.05.

Variables are expressed as the mean ± SD, n (%). RDW: Red blood cell distribution width; T2DM: Type 2 diabetes mellitus; BMI: Body mass index; CHD: Coronary heart disease; TNM: Tumor node metastasis.

Table 2 Comparison between the higher hematocrit group and the lower hematocrit group

Characteristics	Higher hematocrit (n = 2166)	Lower hematocrit (n = 2092)	P value
Hematocrit	42.1 ± 3.0	32.2 ± 4.4	< 0.01^a
Age, yr	61.2 ± 11.3	64.6 ± 12.7	< 0.01^a
Sex			< 0.01^a
Male	1580 (72.9)	933 (44.6)
Female	586 (27.1)	1159 (55.4)
BMI, kg/m²	23.2 ± 3.1	22.2 ± 3.2	< 0.01^a
Smoking	1023 (47.2)	594 (28.4)	< 0.01^a
Drinking	839 (38.7)	476 (22.8)	< 0.01^a
Hypertension	540 (24.9)	573 (27.4)	0.068
T2DM	220 (10.2)	321 (15.3)	< 0.01^a
CHD	68 (3.1)	113 (5.4)	< 0.01^a
Open surgery	222 (10.2)	341 (16.3)	< 0.01^a
Tumor location			< 0.01^a
Colon	782 (36.1)	1226 (58.6)
Rectum	1384 (63.9)	866 (41.4)
TNM stage			< 0.01^a
I	485 (22.4)	318 (15.2)
II	847 (39.1)	900 (43.0)
III	750 (34.6)	764 (36.5)
IV	84 (3.9)	110 (5.3)
Tumor size			< 0.01^a
< 5 cm	1415 (65.3)	1040 (49.7)
≥ 5 cm	751 (34.7)	1052 (50.3)
Operation time (min)	228.1 ± 85.4	226.8 ± 81.1	0.593
Blood loss (mL)	96.3 ± 138.0	107.6 ± 157.1	0.012^a
Hospital stay (d)	11.0 ± 7.5	11.6 ± 9.8	0.016^a
Overall complications	419 (19.3)	519 (24.8)	< 0.01^a
Major complications	53 (2.4)	49 (2.3)	0.823

^aP value < 0.05.

Variables are expressed as the mean ± SD, n (%). T2DM: Type 2 diabetes mellitus; BMI: Body mass index; CHD: Coronary heart disease; TNM: Tumor node metastasis.

Table 3 Univariate and multivariate logistic regression analysis of the overall complications

Risk factors	Univariate analysis		Multivariate analysis
Risk factors	OR (95%CI)	P value	OR (95%CI)	P value
Age, yr	1.024 (1.018-1.030)	< 0.01^a	1.018 (1.011-1.025)	< 0.01^a
Sex (male/female)	0.901 (0.777-1.045)	0.166
BMI, kg/m²	0.973 (0.951-0.995)	0.018^a	0.983 (0.959-1.007)	0.160
Hypertension (yes/no)	1.358 (1.158-1.592)	< 0.01^a	1.128 (0.944-1.347)	0.186
T2DM (yes/no)	1.553 (1.270-1.900)	< 0.01^a	1.297 (1.045-1.610)	0.018^a
Tumor location (colon/rectum)	0.966 (0.835-1.117)	0.638
Tumor stage (IV/III/II/I)	1.053 (0.963-1.151)	0.257
Smoking (yes/no)	1.173 (1.012-1.360)	0.034^a	1.255 (1.075-1.464)	0.004^a
Drinking (yes/no)	0.989 (0.845-1.157)	0.893
CHD (yes/no)	1.807 (1.314-2.484)	< 0.01^a	1.365 (0.977-1.908)	0.069
Tumor size (≥ 5/< 5), cm	1.214 (1.049-1.404)	0.009^a	1.059 (0.910-1.234)	0.459
Surgical methods (open/laparoscopic)	2.250 (1.860-2.721)	< 0.01^a	2.056 (1.691-2.500)	< 0.01^a
RDW (lower/higher)	0.735 (0.634-0.852)	< 0.01^a	0.887 (0.749-1.050)	0.163
Hematocrit (lower/higher)	1.376 (1.189-1.591)	< 0.01^a	1.165 (0.981-1.383)	0.082

^aP value < 0.05.

RDW: Red blood cell distribution width; OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; T2DM: Type 2 diabetes mellitus; CHD: Coronary heart disease.

Table 4 Univariate and multivariate analysis of overall survival

Risk factors	Univariate analysis		Multivariate analysis
Risk factors	HR (95%CI)	P value	HR (95%CI)	P value
Age (yr)	1.044 (1.036-1.051)	< 0.01^a	1.038 (1.030-1.046)	< 0.01^a
Sex (female/male)	0.861 (0.730-1.015)	0.074
BMI (kg/m²)	0.959 (0.935-0.984)	0.001^a	0.997 (0.972-1.023)	0.840
T2DM (yes/no)	1.303 (1.038-1.636)	0.022^a	0.941 (0.745-1.189)	0.610
Tumor site (colon/ rectum)	1.422 (1.091-1.853)	0.009^a	0.984 (0.831-1.165)	0.851
Tumor stage (IV/III/II/I)	2.202 (1.979-2.452)	< 0.01^a	2.167 (1.943-2.416)	< 0.01^a
Smoking (yes/no)	1.081 (0.918-1.273)	0.351
Drinking (yes/no)	1.070 (0.901-1.271)	0.438
Hypertension (yes/no)	1.055 (0.879-1.266)	0.564
CHD (yes/no)	1.355 (0.939-1.957)	0.105
Tumor size (≥ 5 cm/< 5 cm)	1.532 (1.305-1.799)	< 0.01^a	1.235 (1.044-1.459)	0.014^a
RDW (lower/higher)	0.664 (0.565-0.780)	< 0.01^a	0.925 (0.774-1.107)	0.396
Hematocrit (lower/higher)	1.693 (1.437-1.995)	< 0.01^a	1.256 (1.041-1.515)	0.017^a
Overall complications (yes/no)	1.903 (1.611-2.248)	< 0.01^a	1.608 (1.357-1.904)	< 0.01^a

^aP value < 0.05.

RDW: Red blood cell distribution width; HR: Hazard ratio; CI: Confidence interval; BMI: Body mass index; T2DM: Type 2 diabetes mellitus.

Table 5 Univariate and multivariate analysis of disease-free survival

Risk factors	Univariate analysis		Multivariate analysis
Risk factors	HR (95%CI)	P value	HR (95%CI)	P value
Age (yr)	1.031 (1.025-1.038)	< 0.01^a	1.027 (1.020-1.033)	< 0.01^a
Sex (female/male)	0.861 (0.730-1.015)	0.058
BMI (kg/m²)	0.975 (0.953-0.997)	0.029^a	1.003 (0.981-1.026)	0.784
T2DM (yes/no)	1.127 (0.911-1.396)	0.271
Tumor site (colon/ rectum)	1.126 (0.975-1.300)	0.107
Tumor stage (IV/III/II/I)	2.120 (1.926-2.334)	< 0.01^a	2.093 (1.900-2.307)	< 0.01^a
Smoking (yes/no)	1.093 (0.944-1.267)	0.234
Drinking (yes/no)	1.104 (0.946-1.288)	0.208
Hypertension (yes/no)	1.036 (0.879-1.220)	0.676
CHD (yes/no)	1.281 (0.917-1.791)	0.147
Tumor size (≥ 5 cm/< 5 cm)	1.363 (1.180-1.574)	< 0.01^a	1.115 (0.962-1.294)	0.149
RDW (lower/higher)	0.713 (0.616-0.824)	< 0.01^a	0.920 (0.783-1.080)	0.308
Hematocrit (lower/higher)	1.509 (1.304-1.747)	< 0.01^a	1.194 (1.013-1.408)	0.035^a
Overall complications (yes/no)	1.705 (1.463-1.987)	< 0.01^a	1.510 (1.293-1.763)	< 0.01^a

^aP value < 0.05.

RDW: Red blood cell distribution width; HR: Hazard ratio; CI: Confidence interval; BMI: Body mass index; T2DM: Type 2 diabetes mellitus; CHD: Coronary heart disease.

Citation: Peng D, Li ZW, Liu F, Liu XR, Wang CY. Predictive value of red blood cell distribution width and hematocrit for short-term outcomes and prognosis in colorectal cancer patients undergoing radical surgery. World J Gastroenterol 2024; 30(12): 1714-1726
URL: https://www.wjgnet.com/1007-9327/full/v30/i12/1714.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i12.1714