Red blood cell distribution width as a prognostic factor of mortality in elderly patients firstly hospitalized due to heart failure

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 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. Methods: 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%). Results: 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. Conclusions: 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