Higher erythrocyte distribution (RDW) is associated with increased in-hospital mortality and re-hospitalization among elderly (> 60) patients, a new study led by researchers from the San Francisco Coordination Center (SFCC) Sutter Health in San Francisco, CA showed.

The results of the retrospective analysis were published this month in Journal of the American Geriatric Society.

“The large variability in erythrocyte size is significantly associated with a worse prognosis in hospitalized elderly patients, indicating a higher mortality, greater risk of early re-admission and longer days in hospital. Risk stratification strategies for hospitalized seniors should include the value of RDW, ”says Steve Cummings, MD, lead author of the study, director of the SFCC and chief researcher at the California Pacific Medical Center Sater (CPMC).

Dr. Cummings and colleagues from the CPMC retrospectively studied 94,617 patients aged> 60 years who were hospitalized between January 2013 and December 2017 at Sutter Health. A total of 167,292 receptions were included. RDW was measured on admission to the hospital and categorized at 1% intervals. The main result was the speed in-hospital mortality; secondary outcomes included a 30-day re-admission and length of hospital stay.

The results showed that the overall in-hospital mortality was 6.3%. As the value of RDW increased, the in-hospital mortality rate increased from 2.7% for the lowest category of RDW to 12.2% for the highest category (p-trend

RDW, the erythrocyte size variation index, has been proposed as a potential marker of worse outcomes in a number of diseases and conditions associated with aging. The biological mechanisms linking high erythrocyte size variability and adverse health outcomes are unknown, but new data support the use of RDW as a marker of biological aging, vulnerability to disease, oxidative stress, and chronic inflammation.

“Predicting the risk of mortality and re-admission is crucial for inpatient care. A clear risk classification strategy for patients can also improve outcomes in clinical practice, ”says Warren Brauner, MD, co-author of the study and CEO of CPMC. “However, there are no strong predictors of mortality or early re-admission that could be applied to many age-related diseases. These findings provide the potential value of RDW, one of the most common laboratory tests conducted for most hospitalized patients as a biomarker for biomarkers. prognosis or vulnerability in hospitalized elderly patients“Dr. Brauner notes the limitation of the study, which included only patients whose RDW values ​​were measured at the time of admission. Patients without RDW values ​​were excluded, which could lead to unknown bias. Nutritional status and inflammatory processes may affect both higher RDW values and worse results, this cannot be confirmed in this study due to lack of sufficient information on nutritional status or inflammatory parameters, or albumin.

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Additional information:
Kyoung Min Kim et al., Greater erythrocyte distribution and worse hospitalization outcomes in elderly patients, Journal of the American Geriatric Society (2022). DOI: 10.1111 / jgs.17819

Provided by Sutter Health

Citation: A new study shows that erythrocyte distribution width predicts prognosis in elderly hospitalized patients (2022, May 24), obtained May 24, 2022 from https://medicalxpress.com/news/2022-05-red-blood-cell -width-prognoses .html

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