Zalyesov Eduard, Shugaev Inna, Prokopov Yanna, Shahory Ron, Chirmicci Stefan, Aizen Efraim
Fliman Geriatric Rehabilitation Hospital, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Ann Geriatr Med Res. 2020 Sep;24(3):211-217. doi: 10.4235/agmr.20.0042. Epub 2020 Sep 17.
Red cell distribution width (RDW) is a prognostic marker in vascular diseases. While increased RDW predicts mortality and outcomes after ischemic stroke, evidence regarding its prognostic significance in stroke rehabilitation is lacking. Thus, the present study investigated the relationship of RDW with stroke, orthopedic, and deconditioning rehabilitation outcomes.
This prospective comparative study included three groups (stroke, orthopedic, and deconditioning) of older adult patients hospitalized for rehabilitation. The patients in each group were divided into two subgroups according to whether they had high (>14.5%) or normal (≤14.5%) RDW levels on admission. Functional outcome was assessed by total and motor FIM (Functional Independence Measure) score changes and efficiency at admission and on discharge.
Of the 234 eligible patients, 108 (46.2%) had high RDW. Of the 50 stroke rehabilitation patients, 13 (26%) had high RDW. FIM change and efficiency scores were significantly lower in patients with high RDW only in the stroke rehabilitation group. However, multiple linear regression analysis showed that high RDW was not independently associated with total and motor FIM gain or total and motor FIM efficiency.
High RDW levels on admission to rehabilitation were associated with poor rehabilitation outcome in stroke patients but were not an independent risk factor for rehabilitation outcomes.
红细胞分布宽度（RDW）是血管疾病的一种预后标志物。虽然RDW升高可预测缺血性中风后的死亡率和预后，但关于其在中风康复中预后意义的证据尚缺乏。因此，本研究调查了RDW与中风、骨科及失能康复预后之间的关系。
这项前瞻性比较研究纳入了三组因康复住院的老年患者（中风、骨科和失能）。根据入院时RDW水平是否高于（>14.5%）或正常（≤14.5%），将每组患者分为两个亚组。通过入院时和出院时的总FIM（功能独立性测量）评分变化和效率来评估功能预后。
在234例符合条件的患者中，108例（46.2%）RDW升高。在50例中风康复患者中，13例（26%）RDW升高。仅在中风康复组中，RDW升高的患者FIM变化和效率评分显著较低。然而，多元线性回归分析显示，高RDW与总FIM和运动FIM的改善或总FIM和运动FIM效率无独立相关性。
康复入院时RDW水平升高与中风患者康复预后不良相关，但不是康复预后的独立危险因素。
