Red Cell Distribution Width Before Intravenous Thrombolysis in Prediction of 1-year Outcome and Mortality in Patients with Acute Ischemic Stroke

2019 ◽  
Author(s):  
Weiyi Ye ◽  
Jia Li ◽  
Xiang LI ◽  
Xuezhi Yang ◽  
Yiyun Weng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Acute Ischemic Stroke ◽  
Red Blood Cell ◽  
Survival Function ◽  
Intravenous Thrombolysis ◽  
Cox Proportional Hazards ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Impact

Abstract Background: It is well known that red blood cell distribution width(RDW)is a parameter reflecting the heterogeneity of red blood cell volume，which recently may be associated with the development of cardiovascular events or mortality in patients after myocardial infarction .However, little is known about the association between RDW and stroke, especially regarding indisputable endpoints such as death. The purpose of the study was to explore the prognostic value of RDW and its effect on mortality among patients with acute ischemic stroke (AIS) undergoing Intravenous thrombolysis (IVT). Methods: We carried out retrospective analysis of acute anterior ischemic strokes cases treated with IVT between January 2016 and March 2018.The effect of RDW on poor outcome (modified Rankin score 3-6) and mortality in 1 year were assessed. Use multivariate logistic regression to explore the predictors. Receiver operating characteristic (ROC) curve was used to evaluate the predictive capability of variables, furthermore, we applied Cox proportional-hazards models to analyze the impact of factors on survival. Results: RDW (Multivariate OR 1.179;95%CI 0.900-1.545,p=0.232) was not associated with clinical outcome. Surviving patients have lower baseline RDW compared with patients who later died. Adding RDW to NIHSS could improve the prediction of the mortality of stroke clinical outcomes. Conclusions: The finding of our study implied that higher RDW was a potential predictive factor of mortality in 1 year in patients with AIS undergoing IVT，but RDW might not be associated with worse survival function among stroke survivors.

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

scholarly journals The U-Shaped Association Between Serum Uric Acid and Red Blood Cell Distribution Width in Acute Ischemic Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Ning Rong ◽  
Pei Zhao ◽  
Jin Yang ◽  
Qing-Lei Fan ◽  
Qiang Zhang ◽  
...  
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Acute Ischemic Stroke ◽  
Serum Uric Acid ◽  
Red Blood Cell ◽  
Turning Point ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

Objective: The U-shaped association between serum uric acid (SUA) and the functional outcome has been found in acute ischemic stroke (AIS). However, it is unclear if SUA is associated with red blood cell morphology in AIS. This study aimed to determine the relationship between SUA and red blood cell distribution width (RDW) in patients with AIS.Methods: A cross-sectional study including 438 consecutive patients with AIS was conducted. SUA and RDW, biochemical parameters that reflect the heterogeneity of red blood cell volume, were evaluated on admission. We evaluated the association between SUA and RDW through linear curve fitting analyses and two-piecewise regression analyses.Results: The association between SUA levels and RDW followed a U-shape in all patients. In females, the values of RDW significantly decreased with the increment of SUA (per mg/dl: β, −1.45; 95% CI: −2.15 to −0.75; p < 0.001) in patients with SUA <3.86 mg/dl and increased with the increment of SUA (per mg/dl: β, 0.60; 95% CI: 0.22–0.97; p = 0.002) in patients with SUA ≥ 3.86 mg/dl. Similar results were observed in males with the turning point of SUA = 4.82 mg/dl. After adjusting for potential confounders, a U-shaped association between SUA and RDW was maintained in females, but no statistical significance was maintained in patients with SUA ≥ 4.82 mg/dl in males (p = 0.206).Conclusion: In the sample of patients with AIS, we found a U-shaped relationship between SUA levels and RDW, with the turning point of SUA (3.96 mg/dl in females and 4.82 mg/dl in males) by the threshold effect analysis.

scholarly journals The Association between Red Blood Cell Distribution Width and Mortality in Critically Ill Patients with Acute Kidney Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Benji Wang ◽  
Huaya Lu ◽  
Yuqiang Gong ◽  
Binyu Ying ◽  
Bihuan Cheng
Keyword(s):  
Acute Kidney Injury ◽  
Blood Cell ◽  
Critically Ill ◽  
Red Blood Cell ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Impact ◽  
Red Blood Cell Distribution

Background. Several investigators have sought risk factors for mortality in acute kidney injury (AKI). However, no epidemiological studies have investigated the impact of red blood cell distribution width (RDW) on prognosis for critically ill patients with AKI. The aim of this study was to investigate the association of RDW with mortality in these patients. Methods. We analyzed data from the MIMIC-III. RDW was measured upon ICU admission. The association between RDW and mortality of AKI was determined using a multivariate logistic regression and was expressed as the adjusted odds ratio with associated 95% confidence interval (CI). We also conducted subgroup analyses to determine the consistency of this association. Results. A total of 14,078 critically ill patients with AKI were eligible for this analysis. In multivariate analysis, adjusted for age and gender and compared with the reference group (RDW 11.1-13.4%) related to hospital mortality, the adjusted ORs (95% CIs) for RDW levels 13.5-14.3%, 14.4-15.6%, and 15.7-21.2% were 1.22 (1.05, 1.43), 1.56 (1.35, 1.81), and 2.66 (2.31, 3.06), respectively. After adjusting for confounding factors, with high RDW linked to an increase in mortality (RDW 15.7-21.2% versus 11.1-13.4%: OR, 1.57; 95% CI, 1.22 to 2.01; P trend <0.0001). A similar trend was observed for 30-day mortality. Conclusions. RDW appeared to be an independent prognostic marker in critically ill patients with AKI and higher RDW was associated with increased risk of mortality in these 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.

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