title: Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute decompensated heart failure.
abstract: BACKGROUND
  Increased red blood cell distribution width (RDW) is associated with adverse outcomes in heart failure. In the present study, we assessed the association between changes in RDW values during hospitalization and long-term prognosis in patients with acute decompensated heart failure (ADHF).
  
  
  METHODS
  We measured the RDW value in 229 consecutive patients with ADHF. Blood samples were obtained at the time of hospital admission and at discharge. Changes in RDW were calculated as the mean difference between RDW values on admission and those at the time of hospital discharge.
  
  
  RESULTS
  Patients were followed up for a median of 692 days. A Kaplan-Meier survival analysis demonstrated that patients whose RDW levels increased during hospitalization had significantly higher all-cause and cardiac-based mortality following heart failure than did patients whose RDW levels decreased during hospitalization. A multivariate Cox regression analysis revealed that change in RDW values during hospitalization, but not the values of RDW and hemoglobin on admission, was independently correlated with all-cause and cardiac-based mortality after adjusting for other risk factors in patients with ADHF.
  
  
  CONCLUSIONS
  These data document that the change in RDW values during hospitalization independently predicts poor outcomes in patients with ADHF. Continuous follow-up of RDW values could provide useful information for long-term prognosis after heart failure.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan. Electronic address: yusuke0307@kosei.anjo.aichi.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Uemura
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Shibata
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takemoto
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Uchikawa
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Koyasu
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mitsuda
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Miura
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Imai
authors.affiliation: Division of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Watarai
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004909:Erythrocyte Indices; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
chemical_list: D006454:Hemoglobins
keywords: Acute decompensated heart failure; Mortality; Red blood cell distribution width