Red blood cell distribution width predicted mortality in adults older than 45

Data from a national representative study suggest that red blood cell distribution width may be a strong predictor for mortality from cardiovascular disease, cancer and other causes in people aged 45 years or older.

Researchers examined whether higher levels of red blood cell distribution width increased the risk for mortality among 8,175 participants originally included in the Third National Health and Nutrition Examination Survey, 1988-1994. Follow- up for mortality continued until Dec. 31, 2000.

Results indicated that red blood cell distribution width ranged from 11% to 30.6%. When compared with participants with lower red blood cell distribution width values, participants with higher values were more likely to be older, have a higher BMI, be current smokers and less educated.

Compared with the lowest quintile of red blood cell distribution width, the adjusted HR for all-cause mortality for the second quintile was 1.1 (95% CI, 0.9-1.3); 1.2 for the third quintile (95% CI, 1.0-1.4); 1.4 for the fourth quintile (95% CI, 1.2-1.8); and 2.1 for the fifth quintile (95% CI, 1.7-2.6).

For each 1% that red blood cell distribution width increased there was a 22% increase in all-cause mortality (95% CI, 1.15-1.30).

Specifically, the risk of dying from CVD was found to be two- to threefold higher in people with red blood cell distribution width in the fourth and fifth quintiles. Increased mortality from cancer and other causes was also associated with red blood cell distribution width. – by Jennifer Southall

Patel KV. Arch Int Med.2009;169:515-523

This is a strange and unexpected association. The Hippocratic writers, who were very interested in prognostics, would take note, but I don't think we should get a red blood cell distribution width value to advise our patients.

– Wendell Rosse, MD

HemOnc Today Editorial Board member