Red blood cell distribution width as a prognostic factor of mortality in elderly patients firstly hospitalized due to heart failure

Abstract

BACKGROUND Red blood cell distribution width (RDW) is a risk factor related to adverse outcome in patients with heart failure (HF). Less is known about its role in patients in their first hospitalization for HF. AIMS Our objective was to investigate the prognostic role of RDW in elderly patients hospitalized for acute HF for the first time. METHODS We reviewed all patients aged 65 years or older admitted to a tertiary-care university hospital with a main diagnosis of acute HF during a 2-year period (January 2013 to December 2014). Patients were divided into 2 groups according to admission RDW values (<15% or ≥15%). RESULTS A total of 897 patients were included in the study. Mean (SD) age was 80.25 (7.6) years. Admission RDW was 15% or higher in 474 patients (52.8%), with a mean (SD) RDW of 15.5% (2.3%). Multivariable analysis confirmed the relationship between a higher RDW on admission and a previous diagnostic history of diabetes and higher serum sodium concentrations on admission. All-cause mortality was higher among patients with RDW of 15% or more at 1 year follow-up (29.6% vs 23.2%, P = 0.03). Multivariate analysis confirmed the association between RDW and higher risk of 1-year mortality, as well as with older age, higher Charlson comorbidity index, higher potassium serum concentrations, and no hypertension as a previous diagnosis. CONCLUSIONS In elderly patients experiencing their first admission due to acute HF, a higher RDW at baseline might help identify those at higher risk for 1-year all-cause mortality.