The Relation Between Red Cell Distribution Width Of Patients With Heart Failure And Their Cardiac Function And The Analysis Of Mortality Risks In Hospital

Objectives: To investigate the relation between red cell distribution width (RDW) of patients with heart failure(HF) and cardiac function class of New York Heart Association(NYHA) ; to assess clinically the mortality risk in in-hospital patients.Methods: One thousand and ten patients'clinical records were gathered in the past five years.The fundmental files,routine laborotary blood tests and biochemical laborotary parameters of in-hospital patients on their admission were studied retrospectively.The heart failure group was divided into three subgroups(NYⅡ, NYⅢ, NYⅣ) according to the standard by the NYHA.The differrent levels of RDW of the three subgroups were compared.Then these patients were divided into mortality and non- mortality groups based on whether the patients died or not in hospital.The risk factors were analyzed by the t'test and Pearson'sχ2 test.The significant risk factors were analyzed by the multivariable logistic regression model to observe the odds ratio(OR).Results:The RDW of NYⅡgroup was lower than the NYⅢgroup and the NYⅣgroups(P<0.05). With the aggravating of cardiac function, RDW was concomitantly increased. The RDW(%)of the three groups respectively were: NYⅡ(13.9+1.6), NYⅢ(14.9+1.7), NYⅣ(15.5+1.4). The single factor analysis of mortality and non-mortality groups demonstrated that: the LVEF, LVEDD, HB, HCT, RBC, PAB, PAB of mortality group were lower than those of non-mortality group; the RDW, CR, BUN, ALT, AST were higher than those of non-mortality group.; the differences in age, sex ratio, lung infections, causes of diseases, WBC,NEU between two groups were not statistically significant(P>0.05) but the differences were of statistical significance among NYⅡ, NYⅢ, NYⅣgroups. Multivariable logistic regression model analysis was used to analyze the significant risk factors of mortality and non-mortality groups indicated that NYHA standard, RDW, BUN, ALT were all statistically signigicant and that they were independent risk factors. The regression coefficient of RDW was 0.157; OR was 1.170(P=0.028,95% CI:1.018~1.345). For every 1% increase in RDW, the risk of heart failure mortality increased 1.170 times. When the confunding factors like heart function and HB were controlled, RDW still remained as an independent risk factor in in-hospital mortality: the higher the RDW, the higher risk of in-hospital mortality.Conclusion:The base line levels of the RDW are relevant to the cardiac function classification of patients with heart failure.With the increasing of NYHA grades,RDW was concomitantly increased and hinted the relation to the seriousness degree of the cardiac inadiquancy.The higher level of RDW was the independent risk factor for in-hospital morality of patients with the heart failure of the NYHAⅡ-Ⅳclass .