title: Red blood cell distribution width as an effective tool for detecting fatal heart failure in super-elderly patients.
abstract: OBJECTIVE
  Red blood cell distribution width (RDW) is a numerical measure of erythrocyte size variation. It has been recently reported to be an independent prognostic marker of heart failure (HF). Previous studies on RDW were mostly designed for middle-aged and elderly patients (60-79 years old), therefore, there is no established limit for super-elderly patients (≥ 80 years old). The purpose of this study was to evaluate RDW as an effective tool to detect fatal HF in super-elderly patients.
  
  
  METHODS
  The medical records and death certificates of 160 consecutive patients admitted to the Department of Cardiology in Juntendo Tokyo Koto Geriatric Medical Center and who died from June 2002 to October 2010 were reviewed. The causes of death were reviewed, and the factors, including RDW, that might have been related to the fatal HF were evaluated using multivariate logistic regression analysis.
  
  
  RESULTS
  HF was the major cause of death [52 patients (32.5%), 29 females, age 84.0 ± 7.5 years], followed by pneumonia (18.8%, 30/160), and acute myocardial infarction (16.3%, 26/160). The most common cause of HF was atrial fibrillation (36.6%, 19/52), followed by hypertensive heart disease (19.2%, 10/52) and valvular disorders (17.3%, 9/52). The multivariate logistic regression analysis found that a high RDW (≥ 16.5%) was an independent factor related to fatal HF (OR 2.36, 95% CI 1.10, 5.04, p=0.03).
  
  
  CONCLUSIONS
  HF was the major cause of death, and RDW ≥ 6.5 was significantly associated with fatal HF in super-elderly patients.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Japan. ynishiza@juntendo.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishizaki
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamagami
authors.forename: Hikaru
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Joki
authors.forename: Shuuhei
authors.initials: S
authors.lastname: Takahashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sesoko
authors.forename: Haruyo
authors.initials: H
authors.lastname: Yamashita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kuremoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004909:Erythrocyte Indices / Q000502:physiology*; D004912:Erythrocytes / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies