Red Cell Distribution Width as a Prognostic Indicator in Acute Medical Admissions

Area of Science:

• Hematology
• Clinical Medicine
• Prognostic Biomarkers

Background:

• Red cell distribution width (RDW) quantifies red blood cell volume variation.
• Mean corpuscular volume (MCV) is the average red blood cell volume.
• RDW is a readily available laboratory parameter.

Purpose of the Study:

• To evaluate the predictive value of RDW for patient outcomes after acute medical admission.
• To assess RDW's association with both short-term and long-term mortality.
• To quantify the impact of RDW on survival duration.

Main Methods:

• Retrospective analysis of 10-year acute medical admissions (2002-2011) with long-term follow-up to 2021.
• RDW categorized into quintiles (Q1-Q5).
• Logistic and Cox regression models used to assess RDW's predictive value for mortality, with adjusted odds ratios (aORs) calculated.

Main Results:

• 62,184 admissions (35,140 patients) were analyzed.
• 30-day in-hospital mortality was 5.9% (3646 deaths).
• Long-term mortality by 2021 was 42.9% (15,086 deaths).
• Admission RDW independently predicted 30-day mortality (aOR 1.93) and long-term mortality (aOR 1.04).
• Patients in the highest RDW quintile (Q5) experienced a 5.7-year reduction in median survival.

Conclusions:

• Admission RDW is an independent predictor of 30-day in-hospital mortality.
• Admission RDW is an independent predictor of long-term mortality.
• Elevated RDW levels are associated with significantly reduced survival post-acute medical admission.