Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart Failure (RE-AHF) study

Melchio, Remo; Rinaldi, Gianluca; Testa, Elisa; Giraudo, Alessia; Serraino, Cristina; Bracco, Christian; Spadafora, Laura; Falcetta, Andrea; Leccardi, Stefano; Silvestri, Alberto; Fenoglio, Luigi

doi:10.1007/s11739-018-1958-z

Cited by 34 publications

(42 citation statements)

References 36 publications

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“…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%

“…The cut-off level of RDW was the same as or very close to the level of 14.6-15.0 in the literature. 6,8,18,22,23 As shown in Table 4, the mean hospital stay in the former subgroup was 19.2 AE 9.2 days, whereas that in the latter was 13.9 AE 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. The primary outcome of group A was summarized in Table 4.…”

Section: Primary Outcome and Rdwmentioning

confidence: 89%

“…6,8,25 In-hospital elevation of RDW is associated with increased mortality in HF patients. 7,22 In contrast, RDW decrement during hospitalization is not fully documented. In the present study, in-hospital RDW was not reduced significantly (P = 0.09, n = 64), despite the successful treatment of HF yielding a marked reduction in BNP (P < 0.01).…”

Section: Discussionmentioning

confidence: 99%

“…Many investigations have used RDW on admission as a parameter predicting mortality and morbidity of HF, and some studies investigated serial changes of RDW during hospitalization . In‐hospital elevation of RDW is associated with increased mortality in HF patients . In contrast, RDW decrement during hospitalization is not fully documented.…”

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: Resultssupporting

confidence: 64%

Section: Primary Outcome and Rdwmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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 cell distribution width is associated with short‐term mortality in critically ill patients with heart failure

et al. 2022

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Aims There is limited evidence for the correlation between short-term mortality and red cell distribution width (RDW) in critical patients with heart failure. Herein, a retrospective cohort study was conducted to investigate whether RDW was independently associated with short-term mortality in critically ill patients with heart failure. Methods and resultsAs a retrospective cohort study, it involved a total of 9465 patients with heart failure from the MIMIC-IV database. The target-dependent and independent variables were in-hospital mortality, 90 day mortality and RDW measured at baseline, respectively. The relationship between all-cause death and baseline RDW in hospital and after 90 days of admission to ICU was evaluated by using the Kaplan-Meier plot and Cox proportional hazard analysis. The average age of participants was 74.4 (64.2, 83.5) years old, among whom about 54.6% were male. Results of the adjusted Cox proportional hazard model revealed that RDW had a positive association with both in-hospital and 90 day mortality risk after the adjustment of confounders (HR = 1.09, 95% CI: 1.04-1.15, P < 0.001; HR = 1.11, 95% CI: 1.08-1.14, P < 0.001, respectively). A non-linear relationship was found between RDW and 90 day mortality, which had a threshold of 14.96%. The effect sizes and confidence intervals below and above the threshold were 1.36 (1.14 to 1.62) and 1.09 (1.04 to 1.15), respectively. It was also found by subgroup analysis that there were stronger correlations in male and patients with normal renal function. Conclusions Our data suggest that the short-term mortality of critically ill patients with HF is independently predicted by RDW. At the same time, large prospective research and longer follow-up time are required to further validate the findings of this study.Keywords Red cell distribution width; Critically ill patients with heart failure; Prognosis

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Red cell distribution width as a prognosticator in patients with heart failure

et al. 2022

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Aims Increased red cell distribution width (RDW) is a poor prognostic factor in patients with heart failure (HF). However, only a few large‐scale studies have identified the clinical utility of RDW after adjusting for covariates affecting RDW. Methods and results From January 2010 to April 2021, we retrospectively enrolled patients diagnosed with HF from three referral hospitals with available RDW data (taken within 3 months of HF diagnosis) using an integrated clinical data system. Patients with an ejection fraction (EF) < 50% or HFA‐PEFF (Heart Failure Association Pre‐test assessment, Echocardiography and natriuretic peptide, Functional testing, Final aetiology) score ≥ 2 without severe valvular heart disease or coronary revascularization were enrolled. The primary endpoint was all‐cause mortality, and cardiovascular mortality was also collected. Multivariable Cox regression analysis and stabilized inverse probability of treatment weighting (IPTW) were used to identify any association between RDW and all‐cause death by balancing covariates or compounding factors. The global χ 2 score was calculated and discrimination analysis was performed to evaluate the incremental value of RDW in predicting prognosis. Among the 6599 participants enrolled in this study, 1256 (19.0%) cases of all‐cause death occurred, and the median duration of follow‐up was 887 (interquartile range 351–1589) days. Elevated RDW at the initial diagnosis was associated with poor prognosis [cumulative incidence: 819 (30.2%) vs. 437 (11.2%), relative risk 1.58, 95% confidence interval (CI) 1.51–1.67, log‐rank P < 0.001]. Multivariable Cox analysis showed that elevated RDW was a poor prognostic factor for the primary endpoint [hazard ratio (HR) 1.11, 95% CI 1.06–1.16, P < 0.001], independent of clinical risk factors, N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), and EF, which was concordant with the stabilized IPTW (HR 1.29, 95% CI 1.10–1.49, P < 0.001). Adding RDW to model composed of traditional risk factors, NT‐proBNP, and echocardiographic parameters showed incremental prognostic value for predicting poor prognosis (area under the receiver operating characteristic curve, 0.799–0.826; P < 0.001). Conclusions Increased RDW at the time of diagnosis is associated with poor prognosis in patients with HF, independent of clinical risk factors, such as NT‐proBNP, and echocardiographic parameters. Therefore, RDW may aid in the management of these patients beyond traditional risk factors.

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Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart Failure (RE-AHF) study

Cited by 34 publications

References 36 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 cell distribution width is associated with short‐term mortality in critically ill patients with heart failure

Red cell distribution width as a prognosticator in patients with heart failure

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