Red Cell Distribution Width is Associated with All-cause Mortality in Patients with Acute Stroke: a Retrospective Analysis of a Large Clinical Database

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2021 Feb 3

PMID 33530799

Citations 13

Authors

Han Zhao

Yuanchen Zhao

Zhipeng Wu

Yisheng Cheng

Na Zhao

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to evaluate the association between the red blood cell distribution width (RDW) and mortality in patients with stroke.

Methods: We conducted a retrospective cohort study on patients with stroke in the Medical Information Mart for Intensive Care Database III. Cox proportional hazards regression models were used to estimate hazard ratios of 30-day, 90-day, and 1-year mortality in relation to the RDW level.

Results: A total of 4134 patients were enrolled, including 2646 patients with ischemic stroke and 1668 with hemorrhagic stroke. After adjustment for potential confounders, the hazard ratio (95% confidence interval) of 30-day mortality for the second (RDW: 13.4%-14.3%) and third (>14.3%) tertiles was 1.15 (0.96, 1.37) and 1.40 (1.17, 1.68), respectively, compared with the reference group (<13.4%). A two-piecewise linear regression model was established and the inflection point of RDW was 16.7%. When RDW was >16.7%, an increase in RDW did not increase stroke mortality.

Conclusions: The RDW is a prognostic factor of patients with stroke. This finding needs to be confirmed in future prospective studies.

Citing Articles

Association between red cell distribution width-to-lymphocyte ratio and 30-day mortality in patients with ischemic stroke: a retrospective cohort study.

Chen L, Li J, Wang S, Zhao L, Hu S Thromb J. 2024; 22(1):111.

PMID: 39696513 PMC: 11657298. DOI: 10.1186/s12959-024-00671-y.

Association of inflammation/nutrition-based indicators with Parkinson's disease and mortality.

Jia H, Yin K, Zhao J, Che F Front Nutr. 2024; 11:1439803.

PMID: 39355557 PMC: 11442420. DOI: 10.3389/fnut.2024.1439803.

Value of the red blood cell distribution width (RDW) and neutrophil lymphocyte ratio (NLR) in the prediction of functional recovery and 3-month mortality following endovascular treatment for acute anterior circulation ischemic stroke.

Eren A, Giray S Heliyon. 2024; 10(18):e38030.

PMID: 39328526 PMC: 11425159. DOI: 10.1016/j.heliyon.2024.e38030.

Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke.

Xie X, He K, Zhang Y, Wu J Front Neurol. 2024; 15:1425633.

PMID: 39188708 PMC: 11345518. DOI: 10.3389/fneur.2024.1425633.

Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis.

Zhang X, Shen J, Zhou Q, Duan X, Guo Y Medicine (Baltimore). 2024; 103(21):e38306.

PMID: 38788014 PMC: 11124755. DOI: 10.1097/MD.0000000000038306.

References

Lattanzi S, Bartolini M, Provinciali L, Silvestrini M . Glycosylated Hemoglobin and Functional Outcome after Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2016; 25(7):1786-1791. DOI: 10.1016/j.jstrokecerebrovasdis.2016.03.018. View

Owusu B, Stapley R, Honavar J, Patel R . Effects of erythrocyte aging on nitric oxide and nitrite metabolism. Antioxid Redox Signal. 2013; 19(11):1198-208. PMC: 3785809. DOI: 10.1089/ars.2012.4884. View

Ekker M, Verhoeven J, Vaartjes I, Jolink W, Klijn C, de Leeuw F . Association of Stroke Among Adults Aged 18 to 49 Years With Long-term Mortality. JAMA. 2019; 321(21):2113-2123. PMC: 6547225. DOI: 10.1001/jama.2019.6560. View

Huang G, Chen H, Wang Q, Hong X, Hu P, Xiao M . High platelet-to-lymphocyte ratio are associated with post-stroke depression. J Affect Disord. 2018; 246:105-111. DOI: 10.1016/j.jad.2018.12.012. View

Nakashima K, Ohgami E, Kato K, Yoshitomi S, Maruyama T, Harada M . Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection. Geriatr Gerontol Int. 2019; 19(10):988-992. DOI: 10.1111/ggi.13755. View

Turcato G, Cappellari M, Follador L, Dilda A, Bonora A, Zannoni M . Red Blood Cell Distribution Width Is an Independent Predictor of Outcome in Patients Undergoing Thrombolysis for Ischemic Stroke. Semin Thromb Hemost. 2016; 43(1):30-35. DOI: 10.1055/s-0036-1592165. View

Jaddoe V, de Jonge L, Hofman A, Franco O, Steegers E, Gaillard R . First trimester fetal growth restriction and cardiovascular risk factors in school age children: population based cohort study. BMJ. 2014; 348:g14. PMC: 3901421. DOI: 10.1136/bmj.g14. View

Zangari R, Zanier E, Torgano G, Bersano A, Beretta S, Beghi E . Early ficolin-1 is a sensitive prognostic marker for functional outcome in ischemic stroke. J Neuroinflammation. 2016; 13:16. PMC: 4721111. DOI: 10.1186/s12974-016-0481-2. View

Budzianowski J, Pieszko K, Burchardt P, Rzezniczak J, Hiczkiewicz J . The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Dis Markers. 2017; 2017:3041565. PMC: 5646322. DOI: 10.1155/2017/3041565. View

10.

Johnson A, Pollard T, Shen L, Lehman L, Feng M, Ghassemi M . MIMIC-III, a freely accessible critical care database. Sci Data. 2016; 3:160035. PMC: 4878278. DOI: 10.1038/sdata.2016.35. View

11.

Hou H, Sun T, Li C, Li Y, Guo Z, Wang W . An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes. Sci Rep. 2017; 7:43420. PMC: 5324076. DOI: 10.1038/srep43420. View

12.

. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(5):459-480. PMC: 6459001. DOI: 10.1016/S1474-4422(18)30499-X. View

13.

Ahmad M, Singleton M, Bhave P, Kamel H, Soliman E . Atrial cardiopathy and stroke mortality in the general population. Int J Stroke. 2019; 15(6):650-656. DOI: 10.1177/1747493019876543. View

14.

Ahnstedt H, McCullough L . The impact of sex and age on T cell immunity and ischemic stroke outcomes. Cell Immunol. 2019; 345:103960. PMC: 6832888. DOI: 10.1016/j.cellimm.2019.103960. View

15.

Pinho J, Marques S, Freitas E, Araujo J, Taveira M, Alves J . Red cell distribution width as a predictor of 1-year survival in ischemic stroke patients treated with intravenous thrombolysis. Thromb Res. 2018; 164:4-8. DOI: 10.1016/j.thromres.2018.02.002. View

16.

Danese E, Lippi G, Montagnana M . Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015; 7(10):E402-11. PMC: 4635283. DOI: 10.3978/j.issn.2072-1439.2015.10.04. View

17.

Veeranna V, Zalawadiya S, Panaich S, Patel K, Afonso L . Comparative analysis of red cell distribution width and high sensitivity C-reactive protein for coronary heart disease mortality prediction in multi-ethnic population: findings from the 1999-2004 NHANES. Int J Cardiol. 2013; 168(6):5156-61. DOI: 10.1016/j.ijcard.2013.07.109. View

18.

Jafari M, Di Napoli M, Lattanzi S, Mayer S, Bachour S, Bershad E . Serum magnesium level and hematoma expansion in patients with intracerebral hemorrhage. J Neurol Sci. 2019; 398:39-44. DOI: 10.1016/j.jns.2019.01.027. View

19.

Malavasi V, Proietti M, Spagni S, Valenti A, Battista A, Pettorelli D . Usefulness of Red Cells Distribution Width to Predict Worse Outcomes in Patients With Atrial Fibrillation. Am J Cardiol. 2019; 124(10):1561-1567. DOI: 10.1016/j.amjcard.2019.08.008. View

20.

Ajima M, Pandey P, Kumar K, Poojary N . Assessment of mutagenic, hematological and oxidative stress biomarkers in liver of Nile tilapia, Oreochromis niloticus (Linnaeus, 1758) in response to sublethal verapamil exposure. Drug Chem Toxicol. 2016; 40(3):286-294. DOI: 10.1080/01480545.2016.1219914. View