Conway Richard, Byrne Declan, O'Riordan Deirdre, Silke Bernard
Department of Internal Medicine, St James's Hospital, Dublin 8, D08 NHY1 Dublin, Ireland.
J Clin Med. 2023 Aug 21;12(16):5424. doi: 10.3390/jcm12165424.
The red cell distribution width (RDW) is the coefficient of variation of the mean corpuscular volume (MCV). We sought to evaluate RDW as a predictor of outcomes following acute medical admission. We studied 10 years of acute medical admissions (2002-2011) with subsequent follow-up to 2021. RDW was converted to a categorical variable, Q1 < 12.9 fl, Q2-Q4 ≥ 12.9 and <15.7 fL and Q5 ≥ 15.7 fL. The predictive value of RDW for 30-day in-hospital and long-term mortality was evaluated with logistic and Cox regression modelling. Adjusted odds ratios (aORs) were calculated and loss of life years estimated. There were 62,184 admissions in 35,140 patients. The 30-day in-hospital mortality (n = 3646) occurred in 5.9% of admissions. An additional 15,086 (42.9%) deaths occurred by December 2021. Admission RDW independently predicted 30-day in-hospital mortality aOR 1.93 (95%CI 1.79, 2.07). Admission RDW independently predicted long-term mortality aOR 1.04 (95%CI 1.02, 1.05). Median survival post-admission was 189 months. For those with admission RDW in Q5, observed survival half-life was 133 months-this represents a shortfall of 5.7 life years (33.9%). In conclusion, admission RDW independently predicts 30-day in-hospital and long-term mortality.
红细胞分布宽度（RDW）是平均红细胞体积（MCV）的变异系数。我们试图评估RDW作为急性内科住院后预后的预测指标。我们研究了10年的急性内科住院病例（2002 - 2011年），并随访至2021年。RDW被转换为分类变量，Q1 < 12.9 fl，Q2 - Q4 ≥ 12.9且<15.7 fL，Q5 ≥ 15.7 fL。采用逻辑回归和Cox回归模型评估RDW对30天院内及长期死亡率的预测价值。计算调整后的比值比（aORs）并估计生命年损失。共有35140例患者的62184次住院。30天院内死亡率（n = 3646）发生在5.9%的住院病例中。到2021年12月，又有15086例（42.9%）死亡。入院时的RDW独立预测30天院内死亡率，aOR为1.93（95%CI 1.79, 2.07）。入院时的RDW独立预测长期死亡率，aOR为1.04（95%CI 1.02, 1.05）。入院后的中位生存期为189个月。对于入院时RDW处于Q5的患者，观察到的生存半衰期为133个月，这意味着生命年损失5.7年（33.9%）。总之，入院时的RDW独立预测30天院内及长期死亡率。
