Red blood cell distribution width is associated with frailty in older inpatients in China: Sex differences in a cross-sectional study

Li, Qiuping; Chen, Xi; Han, Botang

doi:10.1016/j.exger.2021.111392

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…To our knowledge, no studies have compared the prognostic value of RDW between male and female patients who received thrombolytic treatment. Some studies have found slightly higher RDW values in females than in males, [27,28] whereas others have reported no sex difference in RDW values between males and females [11,29] . In our study, female patients had a slightly but significantly higher RDW value than male patients (13.1% vs 12.6%; P = .005).…”

Section: Discussioncontrasting

confidence: 63%

“…Some studies have found slightly higher RDW values in females than in males, [27,28] whereas others have reported no sex difference in RDW values between males and females. [11,29] In our study, female patients had a slightly but significantly higher RDW value than male patients (13.1% vs 12.6%; P = .005). We found that the AUC value of RDW for 3month poor outcome was higher in male patients than in female patients: 0.835 (95% CI 0.760-0.894) vs 0.783 (95% CI 0.694-0.857), respectively.…”

Section: Discussionmentioning

confidence: 45%

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Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke

et al. 2021

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This study was performed to determine whether red blood cell distribution width (RDW) is associated with 3-month poor functional outcome in patients undergoing thrombolytic therapy for acute ischemic stroke. RDW was measured in patients with thrombolytic therapy in emergency department. Functional outcome was assessed after 3 months and poor functional outcome was defined as modified Rankin scale 3 to 6. A total of 240 patients were enrolled, and 82 (34.2%) had a poor functional outcome. The median RDW was significantly elevated in patients with a poor functional outcome compare with those with a good outcome. RDW was independently associated with a 3-month poor functional outcome (odds ratio 3.369, 95% confidence interval 2.214–5.125). The optimal RDW cutoff for predicting 3-month poor functional outcome was 12.8%, and the area under the curve for RDW was 0.818 (95% confidence interval 0.761–0.876). The area under the curve for RDW was higher in male patients than in female patients. The RDW correlated positively with the modified Rankin scale score after 3 months and the initial National Institutes of Health Stroke Scale score. Initial higher RDW level is related to a 3-month poor functional outcome in patients undergoing thrombolytic therapy for acute ischemic stroke.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 45%

Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke

et al. 2021

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“…A study that enrolled 3635 community-dwelling older men indicated that participants with a high RDW are more likely to have functional limitations and frailty. 30 Li et al 15 indicated that increased RDW may be closely related to frailty through inflammation. Hou et al 13 proved that frailty is closely associated with RDW in older patients with CHD.…”

Section: Discussionmentioning

confidence: 99%

“…Hou et al 13 indicated that RDW is significantly associated with the risk of frailty in older patients with coronary heart disease (CHD). In addition, studies showed that increased RDW is associated with frailty both in older inpatients and in community-dwelling older people 14 15. However, it is still controversial whether RDW alone can predict frailty 16 17.…”

Section: Introductionmentioning

confidence: 99%

Lower haemoglobin-to-red blood cell distribution width ratio is independently associated with frailty in community-dwelling older adults: a cross-sectional study

Zhu

Wei²,

Yang

et al. 2023

BMJ Open

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ObjectivesThe importance of blood cell markers in frailty has been studied. However, research on haemoglobin-to-red blood cell distribution width ratio (HRR) and frailty in older persons is still limited. We investigated the association between HRR and frailty in older adults.DesignCross-sectional population-based study.SettingCommunity-dwelling older adults older than 65 years were recruited from September 2021 to December 2021.ParticipantsA total of 1296 community-dwelling older adults (age ≥65 years) in Wuhan were included in the study.Main outcome measuresThe main outcome was the presence of frailty. The Fried Frailty Phenotype Scale was used to evaluate the frailty status of the participants. Multivariable logistic regression analysis was performed to determine the relationship between HRR and frailty.ResultsA total of 1296 (564 men) older adults were included in this cross-sectional study. Their mean age was 70.89±4.85 years. Receiver operating characteristic curve analysis showed that HRR is a good predictor of frailty in older people, the area under the curve (AUC) was 0.802 (95% CI: 0.755 to 0.849), and the highest sensitivity was 84.5% and the specificity was 61.9% with the optimal critical values 9.97 (p<0.001). Multiple logistic regression analysis indicated that lower HRR (<9.97) (OR: 3.419, 1.679 to 6.964, p=0.001) is independently associated with frailty in older people, even after adjusting confounding factors.ConclusionLower HRR is closely associated with an increased risk of frailty in older people. Lower HRR may be an independent risk factor for frailty in community-dwelling older adults.

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“…Frailty is an independent predictor of mortality in patients admitted to emergency departments and hospital wards [36][37][38]. Elevated RDW has been shown to associate with frailty besides increased mortality of older ED patients [39][40][41].…”

Section: Introductionmentioning

confidence: 99%

Red cell distribution width and mortality in older patients with frailty in the emergency department

et al. 2023

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Background The red cell distribution width (RDW) reflects the degree of heterogeneity of red blood cells. Elevated RDW is associated both with frailty and with increased mortality in hospital-admitted patients. In this study we evaluate whether high RDW values are associated with mortality in older emergency department (ED) patients with frailty, and if the association is independent of the degree of frailty. Methods We included ED patients with the following criteria: ≥ 75 years of age, Clinical Frailty Scale (CFS) score of 4 to 8, and RDW % measured within 48 h of ED admission. Patients were allocated to six classes by their RDW value: ≤ 13%, 14%, 15%, 16%, 17%, and ≥ 18%. The outcome was death within 30 days of ED admission. Crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for a one-class increase in RDW for 30-day mortality were calculated via binary logistic regression analysis. Age, gender and CFS score were considered as potential confounders. Results A total of 1407 patients (61.2% female), were included. The median age was 85 with an inter-quartile range (IQR) of 80–89, median CFS score 6 (IQR: 5–7), and median RDW 14 (IQR: 13–16). Of the included patients, 71.9% were admitted to hospital wards. A total of 85 patients (6.0%) died during the 30-day follow-up. Mortality rate was associated with RDW increase (p for trend < .001). Crude OR for a one-class increase in RDW for 30-day mortality was 1.32 (95% CI: 1.17–1.50, p < .001). When adjusted for age, gender and CFS-score, OR of mortality for one-class RDW increase was still 1.32 (95% CI: 1.16–1.50, p < .001). Conclusion Higher RDW values had a significant association with increased 30-day mortality risk in frail older adults in the ED, and this risk was independent of degree of frailty. RDW is a readily available biomarker for most ED patients. It might be beneficial to include it in risk stratification of older frail ED patients to identify those who could benefit from further diagnostic assessment, targeted interventions, and care planning.

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Red blood cell distribution width is associated with frailty in older inpatients in China: Sex differences in a cross-sectional study

Cited by 7 publications

References 32 publications

Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke

Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke

Lower haemoglobin-to-red blood cell distribution width ratio is independently associated with frailty in community-dwelling older adults: a cross-sectional study

Red cell distribution width and mortality in older patients with frailty in the emergency department

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