The association of Red cell distribution width and in-hospital mortality in older adults admitted to the emergency department.
BACKGROUND
The objective of the study was to test the hypothesis that elevated red cell distribution width (RDW) at admission increases the risk of mortality in older patients admitted to the emergency department (ED).


METHODS
We performed a retrospective analysis of patients admitted to the ED between May 2013 and October 2013. We included patients who were older than 65 years who visited the ED with any medical problems. Baseline RDW values were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.


RESULTS
A total of 1,990 patients were finally included in this study. The mean age was 75 years (SD 7), and 936 (47 %) subjects were male. The in-hospital mortality rate was 3.76 % (74 patients). RDW values higher in non-survivors than in survivors (15.9 ± 2.5 vs. 13.8 ± 1.7, p < 0.001). Multivariate logistic analysis showed that RDW was associated with all-cause in-hospital mortality after adjusting for other confounding factors.


CONCLUSIONS
RDW value at admission is an independent predictor of all-cause in-hospital mortality among patients older than 65 years. After adjustment for multiple confounders, the all-cause in-hospital mortality rate increased by 21.8% for each 1% increase in RDW.


CONCLUSIONS
These results show that RDW at admission is associated with in-hospital mortality among patients older than 65. Thus, RDW at admission may represent a surrogate marker of disease severity. We caution against using these findings to aid clinical decision-making process until they are externally validated.
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Soo Hyun
SH
Kim
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Jeong Hoon
JH
Yeon
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Kyu Nam
KN
Park
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Sang Hoon
SH
Oh
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Seung Pill
SP
Choi
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Young Min
YM
Kim
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
Han Joon
HJ
Kim
Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea. ycs1005@catholic.ac.kr.
Chun Song
CS
Youn
D000368:Aged; D002423:Cause of Death / Q000639:trends; D016638:Critical Illness / Q000401:mortality*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004909:Erythrocyte Indices / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients; D008297:Male; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
Erythrocyte indices; Mortality; Older adults