红细胞分布宽度与血小板比值与急性缺血性脑卒中患者短期和长期死亡风险的关系。
Association between red cell distribution width-to-platelet ratio and short-term and long-term mortality risk in patients with acute ischemic stroke.
机构信息
Department of Neurology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, People's Republic of China.
Department of Emergency, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, 430022, People's Republic of China.
出版信息
BMC Neurol. 2023 May 15;23(1):191. doi: 10.1186/s12883-023-03219-1.
BACKGROUND
The objective of this study was to evaluate the association between red cell distribution width/platelet ratio (RPR) and 30-day and 1-year mortality in acute ischemic stroke (AIS).
METHODS
Data for the retrospective cohort study were collected from the Medical Information Mart for Intensive Care (MIMIC) III database. RPR was divided into two groups: RPR ≤ 0.11 and RPR > 0.11. The study outcomes were 30-day mortality and 1-year mortality from AIS. Cox proportional hazard models were utilized to assess the association between RPR and mortality. Subgroup analyses were applied based on age, tissue-type plasminogen activator (IV-tPA), endovascular treatment, and myocardial infarction.
RESULTS
A total of 1,358 patients were included in the study. Short- and long-term mortality occurred in 375 (27.61%) and 560 (41.24%) AIS patients, respectively. A high RPR was significantly associated with increased 30-day [hazard ratio (HR): 1.45, 95% confidence interval (CI): 1.10 to 1.92, P = 0.009] and 1-year mortality (HR: 1.54, 95%CI: 1.23 to 1.93, P < 0.001) in AIS patients. Meanwhile, RPR was found to be significantly related to 30-day mortality in AIS patients aged < 65 years (HR: 2.19, 95% CI: 1.17 to 4.10, P = 0.014), without IV-tPA use (HR: 1.42, 95% CI: 1.05 to 1.90, P = 0.021), without using endovascular treatment (HR: 1.45, 95% CI: 1.08 to 1.94, P = 0.012), and without myocardial infarction (HR: 1.54, 95% CI: 1.13 to 2.10, P = 0.006). Additionally, RPR was associated with 1-year mortality in AIS patients aged < 65 years (HR: 2.54, 95% CI: 1.56 to 4.14, P < 0.001), aged ≥ 65 years (HR: 1.38, 95% CI: 1.06 to 1.19, P = 0.015), with (HR: 1.46, 95% CI: 1.15 to 1.85, P = 0.002) and without using IV-tPA (HR: 2.30, 95% CI: 1.03 to 5.11, P = 0.041), without using endovascular treatment (HR: 1.56, 95% CI: 1.23 to 1.96, P < 0.001), and without myocardial infarction (HR: 1.68, 95% CI: 1.31 to 2.15, P < 0.001).
CONCLUSION
Elevated RPR is associated with a high risk of short-term and long-term mortality in AIS.
背景
本研究旨在评估红细胞分布宽度/血小板比值（RPR）与急性缺血性脑卒中（AIS）30 天和 1 年死亡率之间的关系。
方法
本回顾性队列研究的数据来自医疗信息监护病房（MIMIC）III 数据库。将 RPR 分为两组：RPR≤0.11 和 RPR＞0.11。研究结果为 AIS 的 30 天死亡率和 1 年死亡率。Cox 比例风险模型用于评估 RPR 与死亡率之间的关系。根据年龄、组织型纤溶酶原激活剂（IV-tPA）、血管内治疗和心肌梗死进行亚组分析。
结果
共有 1358 例患者纳入本研究。375 例（27.61%）和 560 例（41.24%）AIS 患者发生短期和长期死亡。高 RPR 与 AIS 患者 30 天[风险比（HR）：1.45，95%置信区间（CI）：1.10 至 1.92，P=0.009]和 1 年死亡率（HR：1.54，95%CI：1.23 至 1.93，P＜0.001）显著相关。同时，RPR 与年龄＜65 岁的 AIS 患者 30 天死亡率显著相关（HR：2.19，95%CI：1.17 至 4.10，P=0.014），无 IV-tPA 使用（HR：1.42，95%CI：1.05 至 1.90，P=0.021），无血管内治疗（HR：1.45，95%CI：1.08 至 1.94，P=0.012），无心肌梗死（HR：1.54，95%CI：1.13 至 2.10，P=0.006）。此外，RPR 与年龄＜65 岁的 AIS 患者 1 年死亡率相关（HR：2.54，95%CI：1.56 至 4.14，P＜0.001），与年龄≥65 岁的患者（HR：1.38，95%CI：1.06 至 1.19，P=0.015），与使用 IV-tPA 的患者（HR：1.46，95%CI：1.15 至 1.85，P=0.002）和未使用 IV-tPA 的患者（HR：2.30，95%CI：1.03 至 5.11，P=0.041），与使用血管内治疗的患者（HR：1.56，95%CI：1.23 至 1.96，P＜0.001）和未使用血管内治疗的患者（HR：1.68，95%CI：1.31 至 2.15，P＜0.001）相关。
结论
升高的 RPR 与 AIS 患者短期和长期死亡率的风险增加相关。
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