Università degli Studi di Milano, Scuola di Specializzazione in Medicina Interna, Milano, Italy
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
Kardiol Pol. 2019 Jun 25;77(6):632-638. doi: 10.33963/KP.14818. Epub 2019 Apr 29.
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 influence in patients in their first hospitalization by HF. Aims: Our objective was to investigate the prognostic role of RDW in elderly patients firstly hospitalized for acute HF.
We reviewed all patients ≥ 65 years old admitted to a tertiary care university hospital with a main diagnosis of acute HF during a two year period (January 2013 to December 2014). Patients were divided in two different groups according to admission RDW values (< or ≥ 15%).
A total of 897 patients were included in the study. Mean age was 80.25 ± 7.6 years. Admission RDW was ≥ 15% in 474 (52.8%) patients, with a mean RDW of 15.5 % ± 2.3. Multivariate analysis confirmed the relationship between a higher admission RDW and a previous diagnostic history of diabetes and admission higher serum sodium concentrations. All-cause mortality was significantly higher among patients with RDW 15% at one year of follow-up (29.6% vs. 23.2%, p 0.026). Multivariate analysis confirmed the association between RDW and higher risk of one-year mortality, as well as with older age, higher Charlson comorbidity Index, higher potassium serum concentrations and no hypertension as a previous diagnosis.
In elderly patients experiencing their first admission due to acute HF, a higher RDW at baseline might help identify patients at higher risk for one-year all-cause mortality.
红细胞分布宽度（RDW）是心力衰竭（HF）患者不良预后的相关危险因素。但对于首次因 HF 住院的患者，其影响知之甚少。
本研究旨在探讨 RDW 在首次因急性 HF 住院的老年患者中的预后作用。
我们回顾了 2013 年 1 月至 2014 年 12 月期间在一家三级护理大学医院因急性 HF 住院的所有年龄≥65 岁的患者。根据入院时 RDW 值（<或≥15%）将患者分为两组。
共纳入 897 例患者，平均年龄为 80.25 ± 7.6 岁。474 例（52.8%）患者入院时 RDW≥15%，平均 RDW 为 15.5%±2.3。多变量分析证实，较高的入院 RDW 与糖尿病的既往诊断史和入院时较高的血清钠浓度有关。在 1 年随访期间，RDW≥15%的患者全因死亡率显著更高（29.6% vs. 23.2%，p=0.026）。多变量分析证实，RDW 与 1 年死亡率升高相关，且与年龄较大、Charlson 合并症指数较高、血清钾浓度较高以及无高血压的既往诊断有关。
在首次因急性 HF 住院的老年患者中，基线时较高的 RDW 可能有助于识别 1 年全因死亡率较高的患者。
