Red Cell Distribution Width in Clinical Prognosis
Summary
Red cell distribution width (RDW) quantifies the variation in the size of circulating erythrocytes and is routinely reported as part of a full blood count. Although originally developed to aid classification of anaemias, RDW has emerged as an independent prognostic marker across a spectrum of diseases. Elevated RDW reflects underlying inflammation, oxidative stress, impaired erythropoiesis and heterogeneity in erythrocyte survival. These pathophysiological processes are integral to the onset and progression of cardiovascular, cerebrovascular, inflammatory and metabolic disorders. In clinical practice, RDW offers a low-cost, widely available indicator that enhances traditional risk models. Its integration into composite scores and ratios with other laboratory parameters has strengthened its predictive power for mortality, adverse cardiovascular events and organ-specific outcomes. Moreover, dynamic changes in RDW during hospitalisation have been associated with prognosis in critical illness. The broad applicability of RDW spans general population screening, risk stratification in chronic disease and monitoring of therapeutic responses, underscoring its global importance as a versatile biomarker.
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Red Cell Distribution Width in Clinical Prognosis publication trend
The graph below shows the total number of articles in red cell distribution width in clinical prognosis across all publications each year (not limited to Nature Index journals).
Technical terms
Red cell distribution width (RDW): A measure of the variability in volume among circulating red blood cells.
RDW-standard deviation (RDW-SD): The absolute dispersion of red blood cell sizes, reported in femtolitres.
Red cell distribution width/albumin ratio (RAR): A composite index dividing RDW by serum albumin concentration to integrate erythrocyte heterogeneity with nutritional and inflammatory status.
Carotid intima-media thickness (CIMT): A non-invasive ultrasound measure of the combined thickness of the carotid artery’s intimal and medial layers, used as a surrogate for atherosclerotic burden.
References
- Relationship between red cell distribution width/albumin ratio and carotid plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China. Cardiovascular Diabetology (2023).
- Incorporating inflammatory biomarkers into a prognostic risk score in patients with non-ischemic heart failure: a machine learning approach. Frontiers in Immunology (2023).
- Red Cell Distribution Width in Relation to Incidence of Stroke and Carotid Atherosclerosis: A Population-Based Cohort Study. PLOS ONE (2015).
- An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Critical Care (2013).
- Red Blood Cell Distribution Width: A Novel Predictive Indicator for Cardiovascular and Cerebrovascular Diseases. Disease Markers (2017).
- Mechanisms Linking Red Blood Cell Disorders and Cardiovascular Diseases. BioMed Research International (2015).
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