Mayor mortalidad en relación con el aumento de la distribución de los eritrocitos (ADE) en enfermos hospitalizados en un servicio de medicina interna
- Ivan Hernández-Betancor 1
- Esther Martín-Ponce 1
- Geraldine Quintero-Platt 1
- Emilio GonzálezReimers 1
- María Blanca Monereo-Muñoz 1
- Carlos Jorge-Ripper 1
- Francisco Santolaria 1
- 1 Servicio de Medicina Interna, Hospital Universitario de Canarias, Universidad de La Laguna, Ofra sn, Tenerife, Islas Canarias, España
ISSN: 1697-5529
Year of publication: 2014
Issue: 10
Pages: 45-53
Type: Article
More publications in: Majorensis: Revista Electrónica de Ciencia y Tecnología
Abstract
Objective: To analyze the prognostic value of RDW and to determine which factors are associated with increased RDW. Method.-We include 310 patients hospitalized in an internal medicine department. We determined comorbidity (Charlson index), organ dysfunction (SOFA), hemoglobin and red cell indices, B12 and iron metabolism, and nutritional status. Results.- During the follow-up from admission 125 patients died with a survival median of 615 days. Long-term mortality was related to an increased RDW. The following factors were related to increased RDW (>14%) and mortality: serum creatinine > 1.2 mg/dl, albumin < 2.8 g/dl, cholesterol < 100 mg/dl, Charlson index > 2, velocity < 1.2 m/s in the 6-minute walking test, alkaline phosphatase > 100 UI/l, SOFA > 2, hypotension (≤ 90 mmHg) and tachypnea. The presence of anemia and low red cell indices MHC and MCHC, were all closely related to increased RDW and mortality. By multivariate analysis (Cox regression) a RDW > 14%, malignancy, CRP > 90 mg/l, creatinine > 1.2 mg/dl, severe malnutrition, handgrip < 33th percentile, inability to perform the 6 m walking test, a Charlson index > 2 and hypotension showed independent predictive value for long term mortality. Conclusion.-The relationship between increased RDW and mortality is related to a network of factors such as disease, malnutrition, organ failure and comorbidity. However, even after controlling for all these conditions, increased RDW showed an independent predictive capacity for mortality.