Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry

Wasilewski, Jarosław; Pyka, Łukasz; Hawranek, Michał; Tajstra, Mateusz; Skrzypek, Michał; Wasiak, Michał; Suliga, Kamil; Bujak, Kamil; Gąsior, Mariusz

doi:10.5603/cj.a2017.0037

Cited by 8 publications

(16 citation statements)

References 29 publications

(47 reference statements)

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“…These findings are compatible with literature reporting that RDW is independent of BNP for predicting HF outcome . Baseline RDW is reported to independently predict the prognosis of patients with acutely decompensated HFpEF, and the same is true in patients hospitalized for the treatment of HF with highly reduced (≤35%) EF . However, in the comparison of HFrEF with HFpEF, all‐cause mortality increased with elevating RDW in patients with HFpEF, but not in those with HFrEF, requiring further comparative investigations …”

Section: Discussionsupporting

confidence: 89%

“…When HF patients in group A were subdivided again by RDW, 35 patients showed RDW ≥15%, and 67 patients showed RDW 15%. The cut‐off level of RDW was the same as or very close to the level of 14.6–15.0 in the literature . As shown in Table , the mean hospital stay in the former subgroup was 19.2 ± 9.2 days, whereas that in the latter was 13.9 ± 8.2 days ( P < 0.01), showing that the HF patients with greater RDW required a longer hospital stay relative to those showing lesser RDW.…”

Section: Resultssupporting

confidence: 64%

“…Approximately half of HF patients die within 5 years after the initial diagnosis . The etiology of HF was mainly hypertensive or ischemic heart diseases (Table ), as in the literature . These are the main underlying diseases causing HF with reduced (<50%) and preserved (≥50%) EF (HFrEF and HFpEF).…”

Section: Discussionmentioning

confidence: 96%

“…CRP on admission was actually 3.22 ± 2.52 mg/dL in group A (Table ), indicating possible overlapping bacterial infection. Aside from inflammation, RDW depends on nutrition, renal function and ferrokinetics, and all of them are insufficient in the geriatric population . RDW seems to be an integrated parameter of the short‐term clinical course of HF, and long‐term RDW variation might refine the risk prediction in HF patients …”

Section: Discussionmentioning

confidence: 99%

“…First, this was a single‐center study associated with a small sample size, and these findings are not generalizable due to the possible selection bias. A large‐scale cohort is standard to study the association of RDW with HF . Second, HF management protocol and antibiotic treatment strategy depend on the discretions of the treating physicians, although the discretions were strictly based on the guidelines of the domestic medical societies .…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection

Nakashima

Ohgami

Kato

et al. 2019

Geriatrics Gerontology Int

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Aim Red cell distribution width (RDW) is a simple, sensitive and cost‐effective parameter, and is associated with pathophysiology of many common diseases. The aim of the present study was to investigate the prognostic role of RDW in older adults hospitalized for the treatment of heart failure (HF) or infection, because both diseases are fatal, especially in the geriatric population. Methods This observational study consecutively enrolled 196 Japanese older (aged ≥75 years) patients hospitalized for the treatment of HF (group A, n = 102) or non‐cardiovascular bacterial infection (group B, n = 94). Baseline and clinical data were extracted from medical records. The observational period was that of hospitalization. The primary end‐point was classified in the order of discharge to the patients’ home, discharge to other facilities and in‐hospital death. Results Longer hospital stay (P < 0.01) and worse prognosis (P < 0.01), including higher in‐hospital mortality, were found in patients showing RDW ≥15% relative to those with RDW <15% in both groups. RDW showed no in‐hospital variation despite successful treatment of acutely decompensated HF in selected patients of group A (n = 64). Conclusions The present study showed the role of RDW in predicting the prognostic outcome of older adults hospitalized for the treatment of HF or infection, indicating that RDW is a stable and reliable parameter in these common diseases. Geriatr Gerontol Int 2019; 19: 988–992.

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Section: Discussionsupporting

confidence: 89%

Section: Resultssupporting

confidence: 64%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection

Nakashima

Ohgami

Kato

et al. 2019

Geriatrics Gerontology Int

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Red blood cell distribution width predicts long-term mortality in critically ill patients with acute kidney injury: a retrospective database study

Jia

Cui

Yang

et al. 2020

Sci Rep

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Acute kidney injury (AKI) is a serious complication in the intensive care unit (ICU), which may increase the mortality of critically ill patients. The red blood cell distribution width (RDW) has proved useful as a predictor of short-term prognosis in critically ill patients with AKI. However, it remains unknown whether RDW has a prognostic value of long-term all-cause mortality in these patients. The data of 18279 critically ill patients with AKI at first-time hospital admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. The tertiles of the RDW values were used to divide subjects into three groups, namely RDW < 13.6% for the low RDW group, 13.6% ≤ RDW < 15.2% for the middle RDW group and RDW ≥ 15.2% for the high RDW group. Demographic data, mortality, 4-year survival time and severity scale scores were compared among groups. The Kaplan-Meier analysis and the Cox regression analysis were performed to assess the impact of RDW on all-cause mortality in AKI patients. The receiver operating characteristic (ROC) curve analysis was done to evaluate the prognostic value of RDW on the long-term outcome of critically ill patients with AKI. The median age of the enrolled subjects was 65.6 years. AKI patients with a higher RDW value had significantly shorter survival time and higher death rate. By the Kaplan-Meier analysis, patients in the higher RDW group presented significantly shorter survival time and higher death rate. The Cox regression model indicated RDW as an independent risk factor of all-cause mortality of AKI patients (HR 1.219, 95% CI, 1.211 to 1.228). By the ROC analysis, RDW appeared more efficient in predicting long-term prognosis as compared with conventional severity scales. The AUC of RDW (95% CI, 0.712 to 0.725) was significantly higher than other severity scale scores. In conclusion, RDW is positively correlated to survival time of 4-year follow-up in critically ill patients with AKI, and RDW is an independent prognostic factor of longterm outcomes of these patients. Acute kidney injury (AKI) is one of the most common complications in critically ill patients, which results in poor prognosis and high risk of death 1. Approximately 57% of patients in the intensive care unit (ICU) were complicated with AKI, and up to 27% died consequently during hospitalization 2. When AKI occurs concomitantly with other severe organ dysfunctions like myocardial infarction or sepsis, the mortality rate is further increased to 45% to 60% 3 .

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Additive prognostic value of red cell distribution width over late gadolinium enhancement on CMR in patients with non-ischemic dilated cardiomyopathy

Lee

Kim

et al. 2020

Sci Rep

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elevated red cell distribution width (RDW) and late gadolinium enhancement on cardiac magnetic resonance (LGe-cMR) are both poor prognostic factors. this study examined the relationship between RDW and LGe-cMR characteristics in patients with non-ischemic dilated cardiomyopathy (nicM), and investigated whether the additive prognostic value of RDW as an integrative systemic factor over LGe-CMR exists or not. A total of consecutive 378 patients who underwent CMR at two general hospitals in South Korea were retrospectively analyzed. the primary endpoint was a composite of all-cause death, hospitalizations due to worsening heart failure and major arrhythmic events. During a mean follow-up period of 40.8 months, 151 (39.9%) patients experienced primary endpoints. The RDW value was significantly higher in patients with LGE than in those without LGE (13.7 ± 1.5% vs. 13.3 ± 1.4%, p = 0.034), but it was not associated with the extent or distribution patterns of the LGE. Addition of RDW into the model with clinical risk factors and LGE-CMR characteristics led to a significant improvement in the prediction of worse outcomes (χ 2 increased from 73 to 82; p = 0.023). RDW could provide incremental predictive value for adverse clinical events beyond LGe-cMR data in nicM patients.

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Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry

Abstract: Background: Previous studies have reported that in patients with heart failure, an increased

Cited by 8 publications

References 29 publications

Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection

Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection

Red blood cell distribution width predicts long-term mortality in critically ill patients with acute kidney injury: a retrospective database study

Additive prognostic value of red cell distribution width over late gadolinium enhancement on CMR in patients with non-ischemic dilated cardiomyopathy

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