Red Cell Distribution Width and the Risk of Death in Middle-aged and Older Adults
By K. Patel, Luigi Ferrucci, W. Ershler, D. Longo, Jack M. Guralnik. Archives of Internal Medicine, 2009
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Background Red cell distribution width (RDW), a component of an electronic complete blood count, is a measure of heterogeneity in the size of circulating erythrocytes. In patients with symptomatic cardiovascular disease (CVD), RDW is associated with mortality. However, it has not been demonstrated that RDW is a predictor of mortality independent of nutritional deficiencies or in the general population. Methods RDW was measured in a national sample of 8175 community-dwelling adults aged 45 and older who participated in the 1988–1994 National Health and Nutrition Examination Survey; mortality follow-up occurred through December 31, 2000. Deaths from all causes, CVD, cancer, and other causes were examined as a function of RDW. Results Higher RDW values were strongly associated with an increased risk of death. Compared to the lowest quintile of RDW, the following were adjusted hazard ratios (HR) for all-cause mortality (and 95 percent confidence intervals): second quintile, 1.1 (0.9–1.3); third quintile, 1.2 (1.0–1.4); fourth quintile, 1.4 (1.2–1.8); fifth quintile, 2.1 (1.7–2.6). For every 1 percent increment in RDW, all-cause mortality risk increased by 22% [HR = 1.22 (1.15–1.30); p<0.001]. Even when analyses were restricted to non-anemic participants or to those in the normal range of RDW (11–15%) without iron, folate, or vitamin B12 deficiency, RDW remained strongly associated with mortality. The prognostic effect of RDW was observed in both middle-aged and older adults for multiple causes of death. Conclusions RDW is a widely-available test that is a strong predictor of mortality in the general population of adults aged 45 and older.
Subfields: Epidemiology, Oncology, Statistics and Probability
View Paper: https://www.semanticscholar.org/paper/b3ce4c6ad5026ebe1f2abeed89f3fe7c0a354569
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Citations in the corpus
- Clonal hematopoiesis in human aging and disease (2019, unknown): “Like several other welldescribed markers in blood cells, such as red cell distributionwidth (84), DNAmethylation clocks (85), and loss of Y chromosome (86), CHIP is associated with multiple adverse outcomes in epidemiological studies.”
- Red blood cell distribution width: A simple parameter with multiple clinical applications (2015, background): “In a further sub-analysis of the NHANES III including 8175 community-dwelling adults aged 45 and older9, Patel et al. reported that older subjects were more likely to have higher RDW values (highest versus lowest quintile of RDW: 66 versus 58 years; p50.”