Association between Red Blood Cell Distribution Width and Hemorrhagic Transformation in Acute Ischemic Stroke Patients

2019 ◽  
Vol 48 (3-6) ◽  
pp. 193-199 ◽  
Author(s):  
Changyi Wang ◽  
Lu Wang ◽  
Di Zhong ◽  
Linghui Deng ◽  
Shi Qiu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Reperfusion Therapy ◽  
Hemorrhagic Transformation ◽  
Cell Distribution ◽  
Distribution Width ◽  
Increased Risk ◽  
Red Blood Cell Distribution

Background: Hemorrhagic transformation (HT) is a frequent complication of acute ischemic stroke (AIS). Red blood cell distribution width (RDW) is a cost-effective parameter associated with incidence and prognosis of cerebrovascular diseases. The purpose of this study was to assess whether RDW is associated with HT in AIS patients. Methods: AIS patients within 24 h from stroke onset between January 1, 2014, and December 31, 2018, were consecutively enrolled. Blood samples were collected. The primary outcome was HT, which was diagnosed by follow-up brain image and classified into hemorrhagic infarct (HI) and parenchymal hematoma (PH). Multivariate logistic regression analysis was performed to determine the relationship between RDW and HT as well as its subtypes. Potential effect modifier was identified by stratified logistic regression analysis. Results: Among the included 1383 patients, 220 (15.9%) developed HT (HI in 103 and PH in 117). Elevated RDW levels were associated with an increased risk of HT when 2 extreme tertiles were compared (OR 1.60, 95% CI 1.04–2.44, p = 0.031). The risk of HT increased stepwise across RDW tertiles (p for trend = 0.042). RDW significantly correlated with HI rather than PH. The association between RDW and HT could be modified by reperfusion therapy (p for interaction = 0.010), with no significant association between RDW and HT among patients underwent reperfusion therapy. Conclusions: Elevated RDW level was related to increased risk of HT among AIS patients without reperfusion therapy.

scholarly journals Red blood cell distribution width is associated with neuronal damage in acute ischemic stroke

Aging ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 9855-9867
Author(s):  
Rong-Hua Hong ◽  
Jian Zhu ◽  
Ze-Zhi Li ◽  
Jian Yuan ◽  
Pei Zhao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Acute Ischemic Stroke ◽  
Red Blood Cell ◽  
Neuronal Damage ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality

2014 ◽  
Vol 111 (02) ◽  
pp. 300-307 ◽  
Author(s):  
Dahlia Weitzman ◽  
Raanan Raz ◽  
Arie Steinvil ◽  
David Zeltser ◽  
Shlomo Berliner ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Cardiovascular Events ◽  
Cardiovascular Morbidity ◽  
Cell Distribution ◽  
Distribution Width ◽  
Major Cardiovascular Events ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Red Blood Cell Distribution

SummaryRed blood cell distribution width (RDW) has been shown to predict cardiovascular mortality in various populations, but studies were less conclusive regarding cardiovascular morbidity. We aimed at evaluating the prognostic effect of RDW on cardiovascular morbidity and allcause mortality in the largest community cohort to date. We utilised the computerised database of a large community based healthcare maintenance organization (HMO) in Israel to identify a cohort of 225,006 eligible patients aged 40 or above who performed a blood count during 2006. We evaluated the relationship between 1% increments of RDW values and major cardiovascular events and all-cause mortality over a period of five years. A total of 21,939 incident cases of a major cardiovascular event and 4,287 deaths were documented during a total of six years of follow up, respectively. In comparison with patients with RDW level <13%, the hazard ratio for total mortality gradually increased to 4.57 (95% confidence interval [CI]: 3.35–6.24, p<0.001) among male patients and to 3.26 (95% CI: 2.49–4.28, p<0.001) among female patients with a RDW of 17% or above. Similar results were evident in anaemic and non-anaemic populations. RDW above 17% was also associated with a modest increased risk of major cardiovascular events in females 1.26 (95% CI: 1.03–1.52, p=0.021), while in men it was not significant, 1.08 (95% CI: 0.82–1.41, p=NS). In conclusion, increasing RDW levels significantly increased risk of cardiovascular morbidity and all-cause mortality. Our observation is evident in both anaemic and non-anaemic patients.

scholarly journals Early Mortality of Brain Infarction Patients and Red Blood Cell Distribution Width

2020 ◽  
Vol 10 (4) ◽  
pp. 196 ◽  
Author(s):  
Leonardo Lorente ◽  
María M. Martín ◽  
Pedro Abreu-González ◽  
Antonia Pérez-Cejas ◽  
Agustín F. González-Rivero ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Brain Infarction ◽  
Meta Analysis ◽  
Early Mortality ◽  
Cell Distribution ◽  
Middle Cerebral Artery Infarction ◽  
Distribution Width ◽  
Red Blood Cell Distribution

Background: Meta-analysis has found that high baseline red blood cell distribution width (RDW) is associated with increased long-term mortality (mortality at one year or more) in ischemic stroke. The objectives of this study were to determine whether there is an association between RDW and 30-day mortality, and to explore whether RDW during the first week of ischemic stroke could be a 30-day mortality biomarker. Methods: We included patients with malignant middle cerebral artery infarction (MMCAI). RDW at days 1, 4, and 8 of MMCAI were determined. The end-point study was 30-day mortality. Results: We found that survivor (n = 37) in respect to non-survivor patients (n = 37) had lower RDW at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.02). The area under curve (95% CI) for prediction of 30-day mortality by RDW at days 1, 4, and 8 of MMCAI were 0.80 (0.69–0.89; p < 0.001), 0.79 (0.66–0.89; p < 0.001), and 0.73 (0.58–0.84; p = 0.02). Regression analysis showed an association between RDW (odds ratio = 1.695; 95% CI = 1.230–2.335; p < 0.001) and 30-day mortality. Conclusions: The association between RDW and early mortality, and the potential role of RDW during the first week of MMCAI as a prognostic biomarker of early mortality were the main novelties of our study.

Red Blood Cell Distribution Width Is an Independent Predictor of Outcome in Patients Undergoing Thrombolysis for Ischemic Stroke

2016 ◽  
Vol 43 (01) ◽  
pp. 030-035 ◽  
Author(s):  
Gianni Turcato ◽  
Manuel Cappellari ◽  
Luca Follador ◽  
Alice Dilda ◽  
Antonio Bonora ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Independent Predictor ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

P0422RED BLOOD CELL DISTRIBUTION WIDTH AND OUTCOME IN SUBJECTS WITH BIOPSY-PROVEN GLOMERULOPATHIES WITHOUT ANEMIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Otilia Popa ◽  
Tudor Popa ◽  
Ana Stanciu ◽  
Nicoleta Petre ◽  
Eugen Mandache ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Kidney Disease ◽  
Lupus Nephritis ◽  
Blood Cell ◽  
Cerebrovascular Disease ◽  
Independent Predictor ◽  
Cell Distribution ◽  
Distribution Width ◽  
Increased Risk

Abstract Background and Aims Red blood cell distribution width (RDW) is a marker of anisocytosis and is mainly modified in anemia. However, elevated RDW has recently been reported to predict cardiovascular risk, was correlated with disease activity in inflammatory conditions such as systemic lupus erythematosus, rheumatoid arthritis and, not the least, was associated with increased risk of end stage kidney disease and proteinuria in chronic kidney disease (CKD) subjects. The current study aims to assess if RDW is an independent predictor for renal replacement therapy (RRT) and mortality in subjects with glomerulopathies (GP). Method This retrospective, single-center study, included 467 subjects with hemoglobin &gt;12 g/dL at presentation, who were histologically diagnosed with primary and secondary glomerulopathies between 1st Jan. 2008 and 31st Dec. 2017 and who were followed for a mean of 52.8 (95%CI 50.7-55) months, until 31st May 2018. Subjects with inadequate biopsy sample were excluded. Those who deceased until the end of the follow-up were not included in the kidney survival analysis. Predictors of mortality were assessed by logistic regression. Kaplan-Meier method was used to evaluate kidney survival. Patients were stratified in two groups according to the median RDW value: low RDW group (RDW≤15%; n=342) and high RDW group (RDW&gt;15%; n=125). RRT initiation and all-cause mortality were the primary endpoints of the study. Results Subjects with high RDW were older [53 (95%CI 48-56) vs. 45 (95%CI 43-47) years; p=0.03], had more frequent cerebrovascular disease (9.7% vs. 2.7%; p=0.003), congestive heart failure (8.1% vs. 1.8%; p=0.002), connective tissue disease (11.3% vs. 3%; p=0.001) and non-hematologic neoplasia (4.8% vs. 0.9%, p=0.01). Furthermore, they had more severe inflammation as suggested by higher erythrocyte sedimentation rate [54.5 (95%CI 43-60) vs. 35 (95%CI 30-40) mm/hour; p=0.002], fibrinogen [630 (95%CI 562-701) vs. 540 (95%CI 514-585 mg/dL; p=0.02], and C reactive protein [3 (95%CI 2-4) vs. 2 (95%CI 2-3); p=0.03], had lower hemoglobin [13.7 (95%CI 13.4-14) vs. 14.1 (95%CI 13.9-14.4) g/dL); p=0.008], and higher proteinuria [4.2 (95%CI 3.1-5.2) vs. 2.4 (95%CI 2.1-2.8) g/g creatinine; p=0.002]. However, the kidney function between the two groups was similar (56.5 vs. 55 ml/min MDRD; p=0.1). Secondary GP were more frequent encountered in high RDW group (42.4% vs. 18.1%; p&lt;0.001), especially amyloidosis (19.2% vs. 4.7%; p&lt;0.001) and lupus nephritis (9.6% vs. 3.5%; p=0.01). During the follow-up period, in high RDW group 26.4% of the subjects died, compared to 11.4% from the other group (p&lt;0.001). In a multivariate logistic regression model, RDW was an independent predictor for mortality [OR 1.5 (95%CI 1.2-15); p=0.007]. Other independent predictors were older age [OR 1.06 (95%CI 1.03-1.08); p&lt;0.001], presence of cerebrovascular disease [OR 3.31 (95%C I1.01-10.8); p=0.04], lower serum albumin [OR 0.48 (95%CI 0.43-0.70), p&lt;0.001] and higher serum creatinine [OR 1.29 (95%CI 1.06-1.57); p&lt;0.001]. There was no difference regarding the frequency of RRT initiation between groups (18% in high RDW group vs. 11% in low RDW group; p=0.07) and the time to kidney death was similar [79.7 (95%CI 72.8-86.6) vs. 87.8 (95%CI 84-91.6) months; log rank p=0.1]. Conclusion In non-anemic subjects with biopsy-proven glomerular disease, a higher RDW seems associated with a higher risk of mortality, but not with kidney survival. In addition, RDW above 15% might point out to a secondary GP, like amyloidosis and lupus nephritis.

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