Lorente Leonardo, Martín María M, Abreu-González Pedro, Pérez-Cejas Antonia, González-Rivero Agustín F, Ramos-Gómez Luis, Argueso Mónica, Solé-Violán Jordi, Cáceres Juan J, Jiménez Alejandro, García-Marín Victor
Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain.
Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, 38010 Santa Cruz de Tenerife, Spain.
Brain Sci. 2020 Mar 26;10(4):196. doi: 10.3390/brainsci10040196.
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.
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.
We found that survivor ( = 37) in respect to non-survivor patients ( = 37) had lower RDW at days 1 ( < 0.001), 4 ( < 0.001), and 8 ( = 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; < 0.001) and 30-day mortality.
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.
荟萃分析发现，高基线红细胞分布宽度（RDW）与缺血性卒中患者长期死亡率（一年或更长时间的死亡率）升高相关。本研究的目的是确定RDW与30天死亡率之间是否存在关联，并探讨缺血性卒中第一周的RDW是否可作为30天死亡率的生物标志物。
我们纳入了恶性大脑中动脉梗死（MMCAI）患者。测定MMCAI第1、4和8天的RDW。研究终点为30天死亡率。
我们发现，存活患者（n = 37）相对于非存活患者（n = 37）在第1天（p < 0.001）、第4天（p < 0.001）和第8天（p = 0.02）的RDW较低。MMCAI第1、4和8天的RDW预测30天死亡率的曲线下面积（95%CI）分别为0.80（0.69 - 0.89；p < 0.001）、0.79（0.66 - 0.89；p < 0.001）和0.73（0.58 - 0.84；p = 0.02）。回归分析显示RDW与30天死亡率之间存在关联（比值比 = 1.695；95%CI = 1.230 - 2.335；p < 0.001）。
RDW与早期死亡率之间的关联，以及MMCAI第一周的RDW作为早期死亡率预后生物标志物的潜在作用是本研究的主要新发现。
