Evidence map›Paper›PMID 36894893›Full record

ArticleBMC emergency medicine2023

Red cell distribution width and mortality in older patients with frailty in the emergency department.

Janne Alakare, Kirsi Kemp, Timo Strandberg, Maaret Castrén, Jukka Tolonen, Veli-Pekka Harjola

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Janne AlakareDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. janne.alakare@hus.fi.
Kirsi KempDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Timo StrandbergUniversity of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland.
Maaret CastrénDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jukka TolonenDepartment of Internal Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Veli-Pekka HarjolaDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Helsinki University Hospital · FIUniversity of Helsinki · FIUniversity of Oulu · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe red cell distribution width (RDW) reflects the degree of heterogeneity of red blood cells. Elevated RDW is associated both with frailty and with increased mortality in hospital-admitted patients. In this study we evaluate whether high RDW values are associated with mortality in older emergency department (ED) patients with frailty, and if the association is independent of the degree of frailty.

methodsWe included ED patients with the following criteria: ≥ 75 years of age, Clinical Frailty Scale (CFS) score of 4 to 8, and RDW % measured within 48 h of ED admission. Patients were allocated to six classes by their RDW value: ≤ 13%, 14%, 15%, 16%, 17%, and ≥ 18%. The outcome was death within 30 days of ED admission. Crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for a one-class increase in RDW for 30-day mortality were calculated via binary logistic regression analysis. Age, gender and CFS score were considered as potential confounders.

resultsA total of 1407 patients (61.2% female), were included. The median age was 85 with an inter-quartile range (IQR) of 80-89, median CFS score 6 (IQR: 5-7), and median RDW 14 (IQR: 13-16). Of the included patients, 71.9% were admitted to hospital wards. A total of 85 patients (6.0%) died during the 30-day follow-up. Mortality rate was associated with RDW increase (p for trend < .001). Crude OR for a one-class increase in RDW for 30-day mortality was 1.32 (95% CI: 1.17-1.50, p < .001). When adjusted for age, gender and CFS-score, OR of mortality for one-class RDW increase was still 1.32 (95% CI: 1.16-1.50, p < .001).

conclusionHigher RDW values had a significant association with increased 30-day mortality risk in frail older adults in the ED, and this risk was independent of degree of frailty. RDW is a readily available biomarker for most ED patients. It might be beneficial to include it in risk stratification of older frail ED patients to identify those who could benefit from further diagnostic assessment, targeted interventions, and care planning.

Indexed as

FrailtyAgedAged, 80 and overEmergency Service, HospitalErythrocyte IndicesFemaleHospital MortalityHumansMalePrognosisRetrospective StudiesBiomarkersEmergency departmentsFrailtyMortalityPrognostic factorRed cell distribution width

Identifiers

PMID36894893
PMCPMC9998144
OpenAlexW4323655862

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.