Cited by 620Inflammatory Biomarkers in Disease PrognosisBlood properties and coagulationErythrocyte Function and Pathophysiology

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Red Blood Cell Distribution Width and the Risk of Death in Middle-aged and Older Adults

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Patel, Kushang V., Ferrucci, Luigi, Ershler, William B., Longo, Dan L., Guralnik, Jack M.·2009·Archives of Internal Medicine

DOI 10.1001/archinternmed.2009.11PMC PMC2765040

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Abstract

BACKGROUND: Red blood cell distribution width (RDW), a component of an electronic complete blood count, is a measure of heterogeneity in the size of circulating erythrocytes. In patients with symptomatic cardiovascular disease (CVD), RDW is associated with mortality. However, it has not been demonstrated that RDW is a predictor of mortality independent of nutritional deficiencies or in the general population. METHODS: Red blood cell distribution width was measured in a national sample of 8175 community-dwelling adults 45 years or older who participated in the 1988-1994 National Health and Nutrition Examination Survey; mortality follow-up occurred through December 31, 2000. Deaths from all causes, CVD, cancer, and other causes were examined as a function of RDW. RESULTS: Higher RDW values were strongly associated with an increased risk of death. Compared with the lowest quintile of RDW, the following were adjusted hazard ratios (HRs) for all-cause mortality (and 95% confidence intervals [CIs]): second quintile, HR, 1.1 (95% CI, 0.9-1.3); third quintile, HR, 1.2 (95% CI, 1.0-1.4); fourth quintile, HR, 1.4 (95% CI, 1.2-1.8); and fifth quintile, HR, 2.1 (95% CI, 1.7-2.6). For every 1% increment in RDW, all-cause mortality risk increased by 22% (HR, 1.22; 95% CI, 1.15-1.30; P < .001). Even when analyses were restricted to nonanemic participants or to those in the reference range of RDW (11%-15%) without iron, folate, or vitamin B(12) deficiency, RDW remained strongly associated with mortality. The prognostic effect of RDW was observed in both middle-aged and older adults for multiple causes of death. CONCLUSION: Red blood cell distribution width is a widely available test that is a strong predictor of mortality in the general population of adults 45 years or older.

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Authors: Patel, K. V., Ferrucci, L., Ershler, W. B., Longo, D. L., & Guralnik, J. M.
Affiliations: National Institutes of Health (US)
ORCID: Patel, Kushang V.
Ferrucci, Luigi
Ershler, William B.
Guralnik, Jack M.
Venue: Archives of Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2009-03-09
Volume: 169
Issue: 5
Pages: 515
ISSN: 0003-9926 (ISSN-L)
DOI: 10.1001/archinternmed.2009.11
PMC: PMC2765040
OpenAlex: W2060671390
Cited by: 618
References: 24
Citations by year: 2026: 28 · 2025: 24 · 2024: 21 · 2023: 40 · 2022: 37 · 2021: 52 · 2020: 45 · 2019: 33 · 2018: 39 · 2017: 43 · 2016: 46 · 2015: 45 · 2014: 48 · 2013: 35 · 2012: 41
FWCI: 13.48
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Archives of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (Z99 AG999999)
Topics: Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
Health Sciences › Medicine › Hematology › Blood properties and coagulation
Health Sciences › Medicine › Physiology (medical) › Erythrocyte Function and Pathophysiology
Keywords: red cell distribution width, all-cause mortality, mortality prediction, complete blood count, middle-aged and older adults, cardiovascular mortality, cancer mortality, nutritional deficiency, iron deficiency, folate deficiency, vitamin B12 deficiency
MeSH terms: Aged, Erythrocyte Indices, Erythrocytes, Female, Humans, Male, Middle Aged, Mortality, Risk Factors

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Red Blood Cell Distribution Width and the Risk of Death in Middle-aged and Older Adults

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