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.