Usefulness of initial red blood cell distribution width as a prognostic factor for predicting 30-day mortality in acute decompensated heart failure patients

ABSTRACT

OBJECTIVE: This study evaluated the efficacy of the initial red blood cell distribution width (RDW) level in the emergency department (ED) to predict the 30-day mortality in patients with acute decompensated heart failure (ADHF). METHODS: A retrospective analysis study of patients who visited the ED and were diagnosed with ADHF from January 2015 to December 2016 was conducted. The patients were divided into the 30-day survival group and non-survival group. The data were obtained from the medical records of the patients, and the blood test results were taken from the initial blood test at the ED. The data and blood test results were compared between the 30-day survival and non-survival groups. Multivariate logistic regression analysis was performed to determine the risk factors for mortality. RESULTS: A total of 626 patients were included. The mean age was 78.5 years and the overall mortality was 15.5%. The non-survival group had higher RDW levels than the survival group (18.0% vs. 14.6%). In a multivariate logistic regression analysis, RDW (odds ratio, 2.242; 95% confidence interval [CI], 1.673−3.005; P<0.001) were considered to be a useful factor for predicting the prognosis. The area under the receiver operating characteristic curve of RDW to predict mortality was 0.848 (95% CI, 0.811–0.886; P<0.001), and the sensitivity and specificity of predicting mortality was 76.3% and 78.1%, respectively, after setting the RDW cutoff value to 15.95%. CONCLUSION: The initial RDW level is a useful prognostic marker for predicting the 30-day mortality in ADHF patients.