Martínez-Velilla Nicolas, Ibáñez Berta, Cambra Koldo, Alonso-Renedo Javier
Geriatric Department, Complejo Hospitalario de Navarra, Pamplona, Spain.
Age (Dordr). 2012 Jun;34(3):717-23. doi: 10.1007/s11357-011-9254-0. Epub 2011 May 5.
We aimed to assess the association between red blood cell distribution width (RDW) and mortality in patients enrolled by a Geriatric Department. One hundred twenty-two patients were followed up during 5 years. The primary end point was all-cause mortality, and hazard ratios were estimated using a Cox proportional hazard model. Higher RDW values were strongly associated with an increased risk of death. Survival curves across RDW quartiles were statistically different according to the log-rank test (p = 0.017). The first quartile presented higher probability of survival compared to the last one. The gradient from lower to higher risk across quartiles was clear both in the 5-year mortality risk and in the mortality rate per 100 person-years, which ranged from 18.9 to 42.6. However, in the Cox regression model after adjusting for age, severity, and other factors, excess risk was only observed in the highest RDW quartile, with a hazard ratio of 2.24 (CI(95%) 1.13-4.42) vs the first quartile. RDW is a good predictor of mortality in hospitalized older adults beyond those with cardiovascular risk factors, and it could serve as an integrative measure of multiple clinical and subclinical processes simultaneously occurring in complex patients.
我们旨在评估老年科收治患者的红细胞分布宽度（RDW）与死亡率之间的关联。122例患者接受了为期5年的随访。主要终点为全因死亡率，采用Cox比例风险模型估计风险比。较高的RDW值与死亡风险增加密切相关。根据对数秩检验，RDW四分位数的生存曲线在统计学上存在差异（p = 0.017）。与最后一个四分位数相比，第一个四分位数的生存概率更高。在5年死亡率风险和每100人年死亡率方面，从低风险到高风险的四分位数梯度均很明显，范围为18.9至42.6。然而，在调整年龄、病情严重程度和其他因素后的Cox回归模型中，仅在最高RDW四分位数中观察到额外风险，与第一个四分位数相比，风险比为2.24（95%置信区间1.13 - 4.42）。RDW是住院老年患者死亡率的良好预测指标，适用于有心血管危险因素以外的患者，并且它可作为复杂患者同时发生的多种临床和亚临床过程的综合指标。
