Xie Xiaorui, He Keli, Zhang Yao, Wu Jianhua
Department of Neurology, Xiangya Changde Hospital, Changde, Hunan, China.
Department of Clinical Laboratory, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, Hunan, China.
Front Neurol. 2024 Aug 12;15:1425633. doi: 10.3389/fneur.2024.1425633. eCollection 2024.
To explore the association of Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) with the risk of three-month unfavorable outcomes in acute ischemic stroke (AIS).
A secondary analysis was conducted based on a prospective cohort study. A total of 1,889 patients with AIS treated in South Korea from January 2010 to December 2016 were enrolled. Multivariable logistic regression was conducted to investigated the independent relationship between HRR and risk of three-month unfavorable outcomes in AIS. Fitted smoothing curves were used to determine non-linear correlations. The recursive method was employed to explore the turning point and build a two-piece linear regression model. In addition, a set of subgroup analyses were carried out to evaluate the relationship between HRR and risk of three-month unfavorable outcomes.
Multivariate analysis in which potential confounders were adjusted for indicated that the risk of unfavorable outcomes was reduced by 10% for each unit increased of HRR [OR = 0.90, 95% CI: 0.84-0.96, = 0.0024]. In addition, a non-linear relationship was observed between HRR and risk of three-month unfavorable outcomes, which had an inflection point of HRR was 10.57. The effect sizes and the confidence intervals on the left side of the inflection point were 0.83 (0.75, 0.91), = 0.0001. On the right side of the inflection point, no association was found between HRR and the risk of three-month unfavorable outcomes.
This study demonstrates a negative association between HRR and risk of three-month unfavorable outcomes. The relationship between HRR and risk of three-month unfavorable outcomes is non-linear. The correlation is negative for HRR values less than 10.57. For, HRR higher than 10.57, HRR is not associated with the risk of three-month unfavorable outcomes.
探讨血红蛋白与红细胞分布宽度比值（HRR）与急性缺血性卒中（AIS）三个月不良结局风险的相关性。
基于一项前瞻性队列研究进行二次分析。纳入2010年1月至2016年12月在韩国接受治疗的1889例AIS患者。采用多变量逻辑回归研究HRR与AIS三个月不良结局风险之间的独立关系。使用拟合平滑曲线确定非线性相关性。采用递归方法探索转折点并建立两段式线性回归模型。此外，进行了一组亚组分析以评估HRR与三个月不良结局风险之间的关系。
调整潜在混杂因素后的多变量分析表明，HRR每增加一个单位，不良结局风险降低10%[比值比（OR）=0.90，95%置信区间（CI）：0.84 - 0.96，P = 0.0024]。此外，观察到HRR与三个月不良结局风险之间存在非线性关系，其拐点处的HRR为10.57。拐点左侧的效应大小和置信区间为0.83（0.75，0.91），P = 0.0001。在拐点右侧，未发现HRR与三个月不良结局风险之间存在关联。
本研究表明HRR与三个月不良结局风险之间存在负相关。HRR与三个月不良结局风险之间的关系是非线性的。对于HRR值小于10.57，相关性为负。对于HRR高于10.57，HRR与三个月不良结局风险无关。
