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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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Metadata

Authors
Patel, K. V., Ferrucci, L., Ershler, W. B., Longo, D. L., & Guralnik, J. M.
Affiliations
National Institutes of Health (US)
ORCID
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
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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