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Significance of red cell distribution width in the differential diagnosis between neurally mediated syncope and arrhythmic syncope in children

Published online by Cambridge University Press:  19 July 2016

Qingyou Zhang
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Yaqi Li
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Ying Liao
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Junbao Du*
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
*
Correspondence to: Professor J. Du, Department of Pediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing 100034, China. Tel: +8610 8357 3165; Fax: +8610 6653 0532; E-mail: junbaodu1@126.com

Abstract

Objectives

The aim of the present study was to explore the predictive value of red cell distribution width as a means to differentiate between neurally mediated syncope and arrhythmic syncope in children.

Method

Patients were divided into a neurally mediated syncope group (n=72) and an arrhythmic syncope group (n=21) on the basis of clinical history, results of the head-up tilt test, electrocardiography, and 24-hour ambulatory electrocardiography. As controls, we recruited 55 healthy children. Red cell distribution width was determined for children in all groups. A receiver operating characteristic curve was drawn to study the predictive effect of red cell distribution width to differentiate between neurally mediated syncope and arrhythmic syncope.

Results

Red cell distribution width was significantly higher in children with neurally mediated syncope than in children with arrhythmic syncope and the control group. A receiver operating characteristic curve on the predictive value of red cell distribution width in differentiating neurally mediated syncope from arrhythmic syncope showed that the area under the curve was 0.841 (95% confidence interval: 0.737–0.945, p<0.05). A red cell distribution width value of 12.8% as the cut-off value yielded a sensitivity of 80.6% and a specificity of 76.2% in discriminating between patients with neurally mediated syncope and arrhythmic syncope.

Conclusion

Red cell distribution width value of ⩾12.8% might be a useful adjunct for primary-care physicians to differentiate neurally mediated syncope from arrhythmic syncope in children.

Type
Original Articles
Copyright
© Cambridge University Press 2016 

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Footnotes

*

They contributed equally to this work.

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