RDW and pro-BNP in predicting short-term mortality in geriatric patients presenting to the emergency department with acute decompensated heart failure

Abstract

To reveal the ability of Red cell Distribution Width (RDW) to predict short-term mortality in geriatric patients presenting to the emergency department with acute heart failure and compare the results with pro B-type Natriuretic Peptide (pro-BNP). This prospective cohort study was conducted to evaluate the data of patients admitted to the emergency department between August 15th, 2021, and November 15th, 2021. The study population enrolled volunteers aged 65 years and over, who presented with acute heart failure signs and symptoms. Demographics, vital parameters, and laboratory parameters were noted. A total of 424 patients were included in the study. The 30 day-mortality rate of the study cohort was 14.4%. Older age, active malignancy, RDW, C-reactive protein, blood urea nitrogen, and pro-BNP were early independent predictors of short-term mortality. pro-BNP was a better predictor than RDW with a greater area under the curve value (0.841 versus 0.752, p=0.045, DeLong equality test). The created multivariate regression model was able to detect the risk of shortterm mortality with high accuracy (area under the curve: 0.943, accuracy: 0.936, sensitivity: 98.1, specificity: 67.2, p<0.001). Initial RDW and pro-BNP were significantly higher in the mortality group among the geriatric patients with acute decompensated heart failure presenting to the emergency department, and pro- BNP was found to be a better predictor of mortality than RDW. RDW presents as a promising hematological marker that aids in the prognosticating short-term mortality in this patient population.