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Red cell distribution width associations with clinical outcomes: A population-based cohort study
Marcello Tonelli1,2, Natasha Wiebe3, Matthew T James1,2
1University of Calgary, Calgary, Alberta, Canada.
Plos One
|March 14, 2019
Summary
Higher red cell distribution width (RDW) and standard deviation of red blood cell distribution (SD-RBC) predict adverse outcomes in the general population. Elevated RDW and SD-RBC are linked to increased mortality and morbidity, with SD-RBC showing stronger associations.
Area of Science:
- Hematology
- Clinical Epidemiology
- Preventive Medicine
Background:
- Elevated red cell distribution width (RDW) is linked to adverse outcomes in chronic disease populations.
- The predictive value of RDW and standard deviation of red blood cell distribution (SD-RBC) in the general population remains unclear.
Purpose of the Study:
- To assess the association between RDW and SD-RBC with various adverse outcomes in the general population.
- To determine if RDW and SD-RBC can serve as prognostic markers for a broad range of health events.
Main Methods:
- A retrospective population-based cohort study utilizing data from Alberta, Canada (2003-2016).
- Included 3,156,863 adults with measured RDW and SD-RBC, analyzed by percentile.
- Outcomes included all-cause mortality, myocardial infarction, stroke, long-term care placement, renal replacement therapy, malignancy, and hospitalization.
Main Results:
- Increased RDW percentiles correlated with higher risks of death, myocardial infarction, stroke, cancer, hospitalization, and long-term care placement.
- Similar associations were observed for SD-RBC, often with stronger effect sizes.
- Neither RDW nor SD-RBC showed an association with end-stage renal disease (ESRD) progression, though SD-RBC was linked to ESRD risk at both low and high values.
Conclusions:
- RDW and SD-RBC are valuable prognostic markers for general populations, particularly for chronic illness-related outcomes.
- SD-RBC may offer superior predictive capability compared to RDW for certain adverse events.
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