Neurology Department, Hospital de Braga, Sete Fontes, São Victor, 4715-243 Braga, Portugal.
School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal..
Thromb Res. 2018 Apr;164:4-8. doi: 10.1016/j.thromres.2018.02.002. Epub 2018 Feb 7.
Red cell distribution width (RDW) has been found to be a prognostic marker in vascular diseases. Increased RDW predicted mortality and outcome after ischemic stroke however, the underlying mechanisms are unclear. Our study aimed to clarify the relation of RDW with stroke severity and 1-year survival.
Single-centre retrospective cohort study based on a prospective database of consecutive patients with acute anterior circulation ischemic stroke treated with intravenous thrombolysis (IVT) in a 9-year period. Clinical characteristics were collected from the registry. Additional information, namely pre-IVT RDW, was retrieved from individual patient records. Information concerning survival during the first year after stroke was collected from the national Health Data Platform.
602 patients were included. Patients in the higher RDW quartiles were older, and more frequently presented hypertension and cardioembolic etiology. RDW was higher in patients who presented early infection and a positive correlation was found between RDW and C-reactive protein. RDW was not associated with admission severity of stroke, neurological status 24 h after stroke or occurrence of symptomatic intracranial hemorrhage (sICH). Patients in the higher quartiles of RDW presented a lower 1-year survival (p < 0.001). After stepwise adjustment for variables of interest, including severity of ischemic stroke, sICH, and response to IVT, RDW remained a predictor of 1-year survival, specifically in patients ≥75 years and in patients with early post-stroke infection.
RDW is a predictor of 1-year survival in patients with ischemic stroke treated with IVT, specifically in older patients and those who develop early infection, and its prediction value is independent from stroke severity and response to IVT.
红细胞分布宽度（RDW）已被发现是血管疾病的预后标志物。RDW 升高预测了缺血性卒中后的死亡率和结局，但其潜在机制尚不清楚。我们的研究旨在阐明 RDW 与卒中严重程度和 1 年生存率的关系。
这是一项基于前瞻性数据库的单中心回顾性队列研究，连续纳入了 9 年内接受静脉溶栓治疗的急性前循环缺血性卒中患者。从登记处收集临床特征。从患者病历中检索到其他信息，即溶栓前 RDW。从国家健康数据平台收集卒中后 1 年内的生存信息。
共纳入 602 例患者。RDW 较高四分位数的患者年龄较大，更常出现高血压和心源性病因。RDW 与早期感染相关，与 C 反应蛋白呈正相关。RDW 与卒中入院严重程度、卒中后 24 小时的神经状态或症状性颅内出血（sICH）的发生无关。RDW 较高四分位数的患者 1 年生存率较低（p<0.001）。在逐步调整了感兴趣的变量，包括缺血性卒中严重程度、sICH 和 IVT 反应后，RDW 仍然是 1 年生存率的预测因素，特别是在年龄≥75 岁的患者和发生卒中后早期感染的患者中。
RDW 是接受 IVT 治疗的缺血性卒中患者 1 年生存率的预测因素，特别是在年龄较大的患者和发生早期感染的患者中，其预测价值独立于卒中严重程度和 IVT 反应。
