Pedro José Vinhais Domingues Videira Reis

Background This study aims to investigate the association between preoperative Red blood cell Distribution Width (RDW) and postoperative outcomes, including myocardial infarction (MI), and mortality. Methods A prospective cohort including all patients submitted to elective vascular arterial surgery at a university hospital. The primary and secondary outcomes were 30‐day mortality and 30‐day MI, respectively. Results Atrial fibrillation, chronic kidney disease (CKD), and dependent functional status were more prevalent in deceased patients. After multivariable analysis, age (adjusted OR 1.08, 95% Confidence Interval [1.01–1.15], p = 0.027) and RDW‐standard deviation (RDW‐SD) (1.08 [1.01–1.16], p = 0.032) remained independent predictors of mortality. Patients with MI had higher rates of diabetes, CKD, dependent functional status, ASA physical status IV, and insulin medication. After multivariable analysis, dependent functional status (4.8 [1.6–15.0], p = 0.007), insulin medication (4.4 [1.5–12.6], p = 0.007) and RDW‐SD (1.10 [1.02–1.19], p = 0.020) were independent predictors of MI. Conclusion RDW‐SD independently predicted postoperative MI and mortality, and may provide valuable information for prevention and early management of adverse outcomes.