Mohindra Ritin, Mishra Utkarash, Mathew Roshan, Negi Narender Singh
Department of Internal Medicine, PGIMER, Chandigarh, India.
Department of Neurology, VMMC & Safdarjung Hospital, New Delhi, India.
Adv J Emerg Med. 2019 Dec 1;4(2):e24. doi: 10.22114/ajem.v0i0.257. eCollection 2020 Spring.
Globally, stroke is one of the leading causes of death and disability-adjusted life-years (DALYs). The red cell distribution width (RDW) is a readily available and inexpensive test which is done routinely as a part of complete blood count in these patients.
In this study, we tried to correlate the RDW with severity of acute ischemic stroke (AIS).
Patients presenting to emergency department (ED) within 24 hours of the onset of clinical signs and symptoms suggestive of AIS were assessed for Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) score followed by non-contrast computed tomography (NCCT) scan. RDW value for all the patients who were included in the study were co-related with the severity of the stroke.
The median (IQR) RDW in the patients with minor stroke on the basis of GCS was 13.5 (13.3-13.5), moderate stroke was 13.8 (13.5-14.4) and with severe stroke was 15.4 (15.1-15.6) (p < 0.001). The median (IQR) RDW in the patients with minor stroke on the basis of NIHSS score was 13.4 (13.2 - 13.6), moderate stroke was 13.8 (13.5-14.3), and moderate to severe stroke was 14.7 (14.5-15.3) and with severe stroke was 15.5 (15.1-15.7) (p < 0.001). The median RDW in patients who were alive was 13.8 (13.5-15.1) and in patients who expired was 15.5 (14.5-15.7) (p = 0.048).
Based on the findings of this study, RDW index has statistically significant correlation with the severity of AIS. So it can potentially be an important parameter to predict the prognosis of AIS patients.
在全球范围内,中风是导致死亡和伤残调整生命年(DALYs)的主要原因之一。红细胞分布宽度(RDW)是一项易于获得且成本低廉的检测项目,在这些患者的全血细胞计数中作为常规检查项目进行。
在本研究中,我们试图将RDW与急性缺血性中风(AIS)的严重程度相关联。
对在临床体征和症状提示AIS发作后24小时内就诊于急诊科(ED)的患者进行格拉斯哥昏迷量表(GCS)和美国国立卫生研究院卒中量表(NIHSS)评分评估,随后进行非增强计算机断层扫描(NCCT)。纳入研究的所有患者的RDW值与中风严重程度相关。
基于GCS的轻度中风患者的RDW中位数(IQR)为13.5(13.3 - 13.5),中度中风为13.8(13.5 - 14.4),重度中风为15.4(15.1 - 15.6)(p < 0.001)。基于NIHSS评分的轻度中风患者的RDW中位数(IQR)为13.4(13.2 - 13.6),中度中风为13.8(13.5 - 14.3),中度至重度中风为14.7(14.5 - 15.3),重度中风为15.5(15.1 - 15.7)(p < 0.001)。存活患者的RDW中位数为13.8(13.5 - 15.1),死亡患者为15.5(14.5 - 15.7)(p = 0.048)。
基于本研究结果,RDW指数与AIS严重程度具有统计学显著相关性。因此,它有可能成为预测AIS患者预后的重要参数。