Feng Xianrong, Zhang Yaodan, Li Qizheng, Wang Baojia, Shen Jie
Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
Front Aging Neurosci. 2023 Nov 21;15:1259668. doi: 10.3389/fnagi.2023.1259668. eCollection 2023.
The hemoglobin to red cell distribution width ratio (HRR) has been experimentally associated with the prognosis of acute ischemic stroke (AIS). However, its relationship with mechanical thrombectomy (MT) for AIS remains unclear. Therefore, this study aimed to investigate the relationship between HRR at admission, follow-up HRR, and clinical outcomes in patients undergoing MT.
Acute ischemic stroke patients undergoing MT were consecutively enrolled from January 2017 to December 2022. Demographic, clinical, and laboratory information were collected. HRR was measured by dividing hemoglobin (Hb) by red cell distribution width (RDW) at admission and after 24 h of MT. Clinical outcomes after 3 months were evaluated using the modified Rankin Scale (mRS). The primary outcome was poor prognosis (mRS > 2) at 3 months, while the secondary outcome was death within 3 months.
A total of 310 patients were analyzed, of whom 216 patients (69.7%) had poor prognosis, and 92 patients (29.6%) died. Patients with a poor prognosis and death had significantly lower HRR levels at admission and after 24 h. HRR at admission was not associated with clinical outcomes according to multivariable logistic regression analysis. However, HRR after 24 h was significantly associated with poor prognosis (adjusted odds ratio [OR]: 0.646, 95% confidence interval [CI]: 0.520-0.803, < 0.001) and death (adjusted OR: 0.615, 95% CI: 0.508-0.744, < 0.001). Receiver-operating characteristic curve analysis demonstrated the predictive ability of HRR after 24 h, with areas under the curves of 0.790 for poor prognosis and 0.771 for death.
Rapidly measurable HRR levels are an independent marker of outcome after MT in AIS patients. This may provide a reliable auxiliary outcome measure for clinical routine and interventional therapy.
血红蛋白与红细胞分布宽度比值（HRR）已通过实验证明与急性缺血性卒中（AIS）的预后相关。然而，其与AIS机械取栓术（MT）的关系仍不明确。因此，本研究旨在探讨接受MT治疗的患者入院时的HRR、随访时的HRR与临床结局之间的关系。
连续纳入2017年1月至2022年12月期间接受MT治疗的急性缺血性卒中患者。收集人口统计学、临床和实验室信息。通过将入院时及MT后24小时的血红蛋白（Hb）除以红细胞分布宽度（RDW）来测量HRR。使用改良Rankin量表（mRS）评估3个月后的临床结局。主要结局为3个月时预后不良（mRS＞2），次要结局为3个月内死亡。
共分析了310例患者，其中216例患者（69.7%）预后不良，92例患者（29.6%）死亡。预后不良和死亡的患者入院时及24小时后的HRR水平显著较低。根据多变量逻辑回归分析，入院时的HRR与临床结局无关。然而，24小时后的HRR与预后不良（调整优势比[OR]：0.646，95%置信区间[CI]：0.520 - 0.803，P＜0.001）和死亡（调整OR：0.615，95%CI：0.508 - 0.744，P＜0.001）显著相关。受试者工作特征曲线分析显示了24小时后HRR的预测能力，预后不良的曲线下面积为0.790，死亡的曲线下面积为0.771。
可快速测量的HRR水平是AIS患者MT后结局的独立标志物。这可能为临床常规和介入治疗提供可靠的辅助结局指标。
