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Relation between changes in red cell distribution width and clinical outcomes in acute decompensated heart failure
Badira F Makhoul1, Amal Khourieh, Marielle Kaplan
1Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
International Journal of Cardiology
|May 8, 2012
Summary
Red blood cell distribution width (RDW) predicts poor outcomes in acute decompensated heart failure (ADHF). Higher RDW and increasing RDW during hospitalization are linked to increased mortality and rehospitalization risk in ADHF patients.
Area of Science:
- Cardiology
- Hematology
- Clinical Medicine
Background:
- Red blood cell distribution width (RDW) is linked to adverse outcomes in heart failure patients.
- The prognostic value of baseline RDW and its changes during hospitalization in acute decompensated heart failure (ADHF) requires further investigation.
Purpose of the Study:
- To investigate the association between baseline RDW and RDW changes during hospitalization with clinical outcomes in ADHF patients.
- To determine if RDW is an independent predictor of morbidity and mortality in ADHF.
Main Methods:
- Prospective study of 614 ADHF patients.
- Baseline RDW and RDW changes during hospitalization were assessed.
- Cox regression models were used to analyze the relationship between RDW and clinical outcomes, adjusting for covariates.
Main Results:
- Higher median RDW was observed in patients who died compared to survivors (15.6% vs. 14.9%, P<0.0001).
- The adjusted hazard ratio for death or rehospitalization was significantly higher in the highest RDW quartile (HR 1.9).
- An increase in RDW during hospitalization was strongly associated with increased mortality risk (HR 1.9 for increasing RDW).
Conclusions:
- RDW is a strong independent predictor of morbidity and mortality in hospitalized ADHF patients.
- An increase in RDW during hospitalization indicates a poor clinical outcome.
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