ArticleFrontiers in nutrition2026
Elevated preoperative red cell distribution width and incident infection after metabolic and bariatric surgery: a cohort study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Red cell distribution width (RDW), an index of erythrocyte size variability associated with inflammation and nutritional status, may have prognostic utility; however, its role in predicting infection after metabolic and bariatric surgery (MBS) remains unclear. Methods: This TriNetX retrospective cohort study included adults undergoing primary MBS from 2010-2025. Elevated preoperative RDW was defined as ≥14.6% across all measurements within 3 months before surgery, while normal RDW ranged from 11.5 to 14.5%. Patients with discordant values were excluded. One-to-one propensity score matching was performed. The primary outcome was incident sepsis within 1 year, and secondary outcomes included pneumonia, surgical site infection (SSI), urinary tract infection (UTI), and intensive care unit (ICU) admission. Results: After matching, 17,735 patients were included in each group. Elevated RDW was associated with an increased risk of sepsis (hazard ratios [HRs] 1.42, 95% confidence interval [CI] 1.15-1.75; Conclusion: Elevated preoperative RDW is associated with distinct temporal patterns of increased 1-year sepsis and pneumonia risks after MBS. RDW may serve as a simple, low-cost biomarker for perioperative risk stratification. Further prospective studies are warranted.
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