Journal article
Red Cell Distribution Width and Mortality in Older Adults: A Meta-analysis
The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.65A(3), pp.258-265
03/2010
DOI: 10.1093/gerona/glp163
PMCID: PMC2822283
PMID: 19880817
Abstract
Background
Red cell distribution width (RDW) is a quantitative measure of variability in the size of circulating erythrocytes with higher values reflecting greater heterogeneity in cell sizes. Recent studies have shown that higher RDW is associated with increased mortality risk in patients with clinically significant cardiovascular disease (CVD). Whether RDW is prognostic in more representative community-based populations is unclear.
Methods
Seven relevant community-based studies of older adults with RDW measurement and mortality ascertainment were identified. Cox proportional hazards regression and meta-analysis on individual participant data were performed.
Results
Median RDW values varied across studies from 13.2% to 14.6%. During 68,822 person-years of follow-up of 11,827 older adults with RDW measured, there was a graded increased risk of death associated with higher RDW values (p < .001). For every 1% increment in RDW, total mortality risk increased by 14% (adjusted hazard ratio [HR]: 1.14; 95% confidence interval [CI]: 1.11-1.17). In addition, RDW was strongly associated with deaths from CVD (adjusted HR: 1.15; 95% CI: 1.12-1.25), cancer (adjusted HR: 1.13; 95% CI: 1.07-1.20), and other causes (adjusted HR: 1.13; 95% CI: 1.07-1.18). Furthermore, the RDW-mortality association occurred in all major demographic, disease, and nutritional risk factor subgroups examined. Among the subset of 1,603 older adults without major age-associated diseases, RDW remained strongly associated with total mortality (adjusted HR: 1.32; 95% CI: 1.21-1.44).
Conclusions
RDW is a routinely reported test that is a powerful predictor of mortality in community-dwelling older adults with and without age-associated diseases. The biologic mechanisms underlying this association merit investigation.
Details
- Title: Subtitle
- Red Cell Distribution Width and Mortality in Older Adults: A Meta-analysis
- Creators
- Kushang V Patel - National Institute on AgingRichard D Semba - Johns Hopkins MedicineLuigi Ferrucci - National Institute on AgingAnne B Newman - University of PittsburghLinda P Fried - Columbia UniversityRobert B Wallace - University of IowaStefania Bandinelli - Azienda Sanitaria di FirenzeCaroline S Phillips - National Institute on AgingBinbing Yu - National Institute on AgingStephanie Connelly - University of Tennessee Health Science CenterMichael G Shlipak - San Francisco VA Medical CenterPaulo H. M Chaves - Johns Hopkins UniversityLenore J Launer - National Institute on AgingWilliam B Ershler - National Institute on AgingTamara B Harris - National Institute on AgingDan L Longo - National Institute on AgingJack M Guralnik - National Institute on Aging
- Resource Type
- Journal article
- Publication Details
- The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.65A(3), pp.258-265
- DOI
- 10.1093/gerona/glp163
- PMID
- 19880817
- PMCID
- PMC2822283
- NLM abbreviation
- J Gerontol A Biol Sci Med Sci
- ISSN
- 1079-5006
- eISSN
- 1758-535X
- Publisher
- Oxford University Press
- Language
- English
- Date published
- 03/2010
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363621202771
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