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Change in red blood cell distribution width during the last years of life in geriatric patients

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Most of the studies that evaluate the association between red blood cell distribution width (RDW) and mortality assess it on a single occasion instead of doing so through serial measurements. Very few studies have investigated repeated measurements of RDW and its prognostic value, and most of them are focused on patients with cardiovascular diseases. RDW is a dynamic value so we aimed at determining the prognostic value of sequential RDW assessment in the last years of life in patients enrolled in a Department of Geriatrics.

Design

This work is part of a prospective study derived from a cohort of 122 patients over 75 years hospitalized in 2005 for the purpose of assessing the prognostic significance of several comorbidity and prognostic indices.

Setting

Patients were consecutively recruited for the study at admission in a tertiary hospital and then followed up for at least 5 years.

Participants

A total of 55 patients with repeated RDW assessments during all the five years before their death were selected from the total cohort of 122 patients.

Results

We found a strong correlation between progressive rise in RDW and mortality risk, especially during the last year of life. There was a gradual significant increase in the RDW values along the last five years of life, with means growing up from 14,8 (95% CI: 13,98-15.62) to 16,37 (15,80-16,94).

Conclusion

In our cohort of geriatric patients, RDW is a dynamic variable that is modified during the last five years of life, irrespective of their age, and especially during the last year.

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References

  1. England JM, Down MC. Red-cell-volume distribution curves and the measurement of anisocytosis. Lancet 1974;1 (7860):701–703

    Article  CAS  PubMed  Google Scholar 

  2. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M, Cholesterol FT, Investigators RET. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008;117 (2):163–168. doi:10.1161/circulationaha.107.727545

    Article  PubMed  Google Scholar 

  3. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB, Investigators C. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. Journal of the American College of Cardiology 2007;50 (1):40–47. doi:10.1016/j.jacc.2007.02.067

    Article  PubMed  Google Scholar 

  4. Hunziker S, Stevens J, Howell MD. Red cell distribution width and mortality in newly hospitalized patients. Am J Med 2012;125 (3):283–291. doi:10.1016/j.amjmed.2011.08.021

    Article  PubMed  Google Scholar 

  5. Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between red cell distribution width and clinical outcomes after acute myocardial infarction. The American journal of cardiology 2010;105 (3):312–317. doi:10.1016/j.amjcard.2009.09.027

    Article  PubMed  Google Scholar 

  6. Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. The American journal of cardiology 2011;107 (8):1241–1245. doi:10.1016/j.amjcard.2010.12.023

    Article  PubMed Central  PubMed  Google Scholar 

  7. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci 2009;277 (1–2):103–108. doi:10.1016/j.jns.2008.10.024

    Article  PubMed  Google Scholar 

  8. Lee WS, Kim TY. Relation between red blood cell distribution width and inflammatory biomarkers in rheumatoid arthritis. Arch Pathol Lab Med 2010;134 (4):505–506. doi:10.1043/1543-2165-134.4.505.c

    PubMed  Google Scholar 

  9. Lee JH, Chung HJ, Kim K, Jo YH, Rhee JE, Kim YJ, Kang KW. Red cell distribution width as a prognostic marker in patients with community-acquired pneumonia. Am J Emerg Med 2013;31 (1):72–79. doi:10.1016/j.ajem.2012.06.004

    Article  PubMed  Google Scholar 

  10. Yesil A, Senates E, Bayoglu IV, Erdem ED, Demirtunç R, Kurdas Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver 2011;5 (4):460–467. doi:10.5009/gnl.2011.5.4.460

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Spell DW, Jones DV, Harper WF, David Bessman J. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004;28 (1):37–42. doi:10.1016/j.cdp.2003.10.002

    Article  PubMed  Google Scholar 

  12. Vayá A, Alis R, Hernández J-L, Calvo J, Micó L, Romagnoli M, Ricarte JM. RDW in patients with systemic lupus erythematosus. Influence of anaemia and inflammatory markers. Clin Hemorheol Microcirc 2013;54 (3):333–339. doi:10.3233/ch-131738

    PubMed  Google Scholar 

  13. Sategna Guidetti C, Scaglione N, Martini S. Red cell distribution width as a marker of coeliac disease: a prospective study. Eur J Gastroenterol Hepatol 2002;14 (2):177–181

    Article  PubMed  Google Scholar 

  14. Weuve J, Mendes de Leon CF, Bennett DA, Dong X, Evans DA. The Red Cell Distribution Width and Anemia in Association With Prevalent Dementia. Alzheimer Dis Assoc Disord 2013. doi:10.1097/WAD.0b013e318299673c

    Google Scholar 

  15. Öztürk ZA, Ünal A, Yigiter R, Yesil Y, Kuyumcu ME, Neyal M, Kepekçi Y. Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer’s disease (AD)? Arch Gerontol Geriatr 2013;56 (1):50–54. doi:10.1016/j.archger.2012.10.002

    Article  PubMed  Google Scholar 

  16. Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009;169 (6):588–594. doi:10.1001/archinternmed.2009.55

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, Wallace RB, Bandinelli S, Phillips CS, Yu B, Connelly S, Shlipak MG, Chaves PHM, Launer LJ, Ershler WB, Harris TB, Longo DL, Guralnik JM. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 2010;65 (3):258–265. doi:10.1093/gerona/glp163

    Article  PubMed  Google Scholar 

  18. Veeranna V, Zalawadiya SK, Panaich S, Patel KV, Afonso L. Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: Findings from the 1999-2004 NHANES. Int J Cardiol 2013;168 (6):5156–5161. doi:10.1016/j.ijcard.2013.07.109

    Article  PubMed  Google Scholar 

  19. Le Couteur DG, Blyth FM, Creasey HM, Handelsman DJ, Naganathan V, Sambrook PN, Seibel MJ, Waite LM, Cumming RG (2010) The association of alanine transaminase with aging, frailty, and mortality. J Gerontol A Biol Sci Med Sci 2010;65 (7):712–717. doi:10.1093/gerona/glq082

    Article  PubMed  Google Scholar 

  20. Willems JM, Trompet S, Blauw GJ, Westendorp RG, de Craen AJ. White blood cell count and C-reactive protein are independent predictors of mortality in the oldest old. J Gerontol A Biol Sci Med Sci 2010;65 (7):764–768. doi:10.1093/gerona/glq004

    Article  PubMed  Google Scholar 

  21. Martínez-Velilla N, Ibáñez B, Cambra K, Alonso-Renedo J. Red blood cell distribution width, multimorbidity, and the risk of death in hospitalized older patients. Age (Dordr) 2012;34 (3):717–723. doi:10.1007/s11357-011-9254-0

    Article  Google Scholar 

  22. Martinez-Velilla N, Ibanez-Beroiz B, Cambra-Contin K, Alonso-Renedo J. Is Comprehensive Geriatric Assessment a Better 1-Year Mortality Predictor Than Comorbidity and Prognostic Indices in Hospitalized Older Adults? J Am Geriatr Soc 2013;61 (10):1821–1823. doi:10.1111/jgs.12488

    Article  PubMed  Google Scholar 

  23. Cauthen CA, Tong W, Jain A, Tang WHW. Progressive rise in red cell distribution width is associated with disease progression in ambulatory patients with chronic heart failure. Journal of cardiac failure 2012;18 (2):146–152. doi:10.1016/j.cardfail.2011.10.013

    Article  PubMed Central  PubMed  Google Scholar 

  24. Makhoul BF, Khourieh A, Kaplan M, Bahouth F, Aronson D, Azzam ZS. Relation between changes in red cell distribution width and clinical outcomes in acute decompensated heart failure. Int J Cardiol 2013;167 (4):1412–1416. doi:10.1016/j.ijcard.2012.04.065

    Article  PubMed  Google Scholar 

  25. Aung N, Dworakowski R, Byrne J, Alcock E, Deshpande R, Rajagopal K, Brickham B, Monaghan MJ, Okonko DO, Wendler O, Maccarthy PA. Progressive rise in red cell distribution width is associated with poor outcome after transcatheter aortic valve implantation. Heart 2013;99 (17):1261–1266. doi:10.1136/heartjnl-2013-303910

    Article  PubMed  Google Scholar 

  26. Arbel Y, Weitzman D, Raz R, Steinvil A, Zeltser D, Berliner S, Chodick G, Shalev V. Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality. A population-based study. Thromb Haemost 2013;111 (2). doi:10.1160/th13-07-0567

    Google Scholar 

  27. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relationship between red blood cell distribution width and kidney function tests in a large cohort of unselected outpatients. Scand J Clin Lab Invest 2008;68 (8):745–748. doi:10.1080/00365510802213550

    Article  CAS  PubMed  Google Scholar 

  28. Kario K, Matsuo T, Nakao K, Yamaguchi N. The correlation between red cell distribution width and serum erythropoietin titres. Clin Lab Haematol 1991;13 (2):222–223

    Article  CAS  PubMed  Google Scholar 

  29. Cheng CK-W, Chan J, Cembrowski GS, van Assendelft OW. Complete blood count reference interval diagrams derived from NHANES III: stratification by age, sex, and race. Lab Hematol 2004;10 (1):42–53

    Article  PubMed  Google Scholar 

  30. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105 (9):1135–1143

    Article  CAS  PubMed  Google Scholar 

  31. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169 (5):515–523. doi:10.1001/archinternmed.2009.11

    Article  PubMed Central  PubMed  Google Scholar 

  32. Semba RD, Patel KV, Ferrucci L, Sun K, Roy CN, Guralnik JM, Fried LP. Serum antioxidants and inflammation predict red cell distribution width in older women: the Women’s Health and Aging Study I. Clin Nutr 2010;29 (5):600–604. doi:10.1016/j.clnu.2010.03.001

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Patel KV, Mohanty JG, Kanapuru B, Hesdorffer C, Ershler WB, Rifkind JM. Association of the red cell distribution width with red blood cell deformability. Adv Exp Med Biol 2013;765:211–16. doi:10.1007/978-1-4614-4989-8_29

    Article  CAS  PubMed  Google Scholar 

  34. Kozlitina J, Garcia CK. Red blood cell size is inversely associated with leukocyte telomere length in a large multi-ethnic population. PLoS One 2012;7 (12):e51046. doi:10.1371/journal.pone.0051046

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  35. Ruocco L, Del Corso L, Romanelli AM, Deri D, Pentimone F. New hematological indices in the healthy elderly. Minerva Med 2001;92 (2):69–73

    CAS  PubMed  Google Scholar 

  36. Fici F, Celik T, Balta S, Iyisoy A, Unlu M, Demitkol S, Yaman H, Brambilla G, Kardesoglu E, Kilic S, Yokusoglu M, Grassi G. Comparative effects of nebivolol and metoprolol on red cell distribution width and neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension. J Cardiovasc Pharmacol 2013;62 (4):388–393. doi:10.1097/FJC.0b013e31829f716a

    Article  CAS  PubMed  Google Scholar 

  37. Nishizaki Y, Yamagami S, Suzuki H, Joki Y, Takahashi S, Sesoko M, Yamashita H, Kuremoto K, Shinozaki T, Daida H. Red blood cell distribution width as an effective tool for detecting fatal heart failure in super-elderly patients. Intern Med 2012;51 (17):2271–2276

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Geriatrics, Servicio de Geriatría del Complejo Hospitalario de Navarra, Irunlarrea 4, 31008, Pamplona, Spain

    Nicolás Martínez-Velilla, A. García-Baztán & J. Alonso-Renedo

  2. Navarrabiomed-Fundación Miguel Servet, Pamplona, Spain

    Nicolás Martínez-Velilla, K. Cambra-Contin & B. Ibáñez-Beroiz

  3. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Pamplona, Spain

    K. Cambra-Contin & B. Ibáñez-Beroiz

  4. Centro de Salud San Juan, Pamplona, Spain

    P. A. Herce

  5. Grupo de Investigación en Geriatría. Navarrabiomed, Pamplona, Spain

    Nicolás Martínez-Velilla, J. Alonso-Renedo & P. A. Herce

Authors
  1. Nicolás Martínez-Velilla
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  2. K. Cambra-Contin
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  3. A. García-Baztán
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  4. J. Alonso-Renedo
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  5. P. A. Herce
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  6. B. Ibáñez-Beroiz
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Correspondence to Nicolás Martínez-Velilla.

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Martínez-Velilla, N., Cambra-Contin, K., García-Baztán, A. et al. Change in red blood cell distribution width during the last years of life in geriatric patients. J Nutr Health Aging 19, 590–594 (2015). https://doi.org/10.1007/s12603-015-0470-7

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  • DOI: https://doi.org/10.1007/s12603-015-0470-7

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