João Pinho1, Sofia Alexandra Marques2, Eduardo Freitas3, José Araújo4, Mariana Taveira5, José Nuno Alves4, Carla Ferreira4. 1. Neurology Department, Hospital de Braga, Sete Fontes, São Victor, 4715-243 Braga, Portugal. Electronic address: joao.pinho@hospitaldebraga.pt. 2. School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.. Electronic address: a69031@alunos.uminho.pt. 3. Neurology Department, Hospital de Santa Luzia, Unidade Local de Saúde do Alto Minho, Estrada de Santa Luzia, 4904-858 Viana do Castelo, Portugal. 4. Neurology Department, Hospital de Braga, Sete Fontes, São Victor, 4715-243 Braga, Portugal. 5. Internal Medicine Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal.
Abstract
INTRODUCTION: Red cell distribution width (RDW) has been found to be a prognostic marker in vascular diseases. Increased RDW predicted mortality and outcome after ischemic stroke however, the underlying mechanisms are unclear. Our study aimed to clarify the relation of RDW with stroke severity and 1-year survival. MATERIAL AND METHODS: Single-centre retrospective cohort study based on a prospective database of consecutive patients with acute anterior circulation ischemic stroke treated with intravenous thrombolysis (IVT) in a 9-year period. Clinical characteristics were collected from the registry. Additional information, namely pre-IVT RDW, was retrieved from individual patient records. Information concerning survival during the first year after stroke was collected from the national Health Data Platform. RESULTS: 602 patients were included. Patients in the higher RDW quartiles were older, and more frequently presented hypertension and cardioembolic etiology. RDW was higher in patients who presented early infection and a positive correlation was found between RDW and C-reactive protein. RDW was not associated with admission severity of stroke, neurological status 24 h after stroke or occurrence of symptomatic intracranial hemorrhage (sICH). Patients in the higher quartiles of RDW presented a lower 1-year survival (p < 0.001). After stepwise adjustment for variables of interest, including severity of ischemic stroke, sICH, and response to IVT, RDW remained a predictor of 1-year survival, specifically in patients ≥75 years and in patients with early post-stroke infection. CONCLUSIONS: RDW is a predictor of 1-year survival in patients with ischemic stroke treated with IVT, specifically in older patients and those who develop early infection, and its prediction value is independent from stroke severity and response to IVT.
INTRODUCTION: Red cell distribution width (RDW) has been found to be a prognostic marker in vascular diseases. Increased RDW predicted mortality and outcome after ischemic stroke however, the underlying mechanisms are unclear. Our study aimed to clarify the relation of RDW with stroke severity and 1-year survival. MATERIAL AND METHODS: Single-centre retrospective cohort study based on a prospective database of consecutive patients with acute anterior circulation ischemic stroke treated with intravenous thrombolysis (IVT) in a 9-year period. Clinical characteristics were collected from the registry. Additional information, namely pre-IVT RDW, was retrieved from individual patient records. Information concerning survival during the first year after stroke was collected from the national Health Data Platform. RESULTS: 602 patients were included. Patients in the higher RDW quartiles were older, and more frequently presented hypertension and cardioembolic etiology. RDW was higher in patients who presented early infection and a positive correlation was found between RDW and C-reactive protein. RDW was not associated with admission severity of stroke, neurological status 24 h after stroke or occurrence of symptomatic intracranial hemorrhage (sICH). Patients in the higher quartiles of RDW presented a lower 1-year survival (p < 0.001). After stepwise adjustment for variables of interest, including severity of ischemic stroke, sICH, and response to IVT, RDW remained a predictor of 1-year survival, specifically in patients ≥75 years and in patients with early post-stroke infection. CONCLUSIONS: RDW is a predictor of 1-year survival in patients with ischemic stroke treated with IVT, specifically in older patients and those who develop early infection, and its prediction value is independent from stroke severity and response to IVT.
Authors: Marcello Tonelli; Natasha Wiebe; Matthew T James; Christopher Naugler; Braden J Manns; Scott W Klarenbach; Brenda R Hemmelgarn Journal: PLoS One Date: 2019-03-13 Impact factor: 3.240
Authors: Nuria P Torres-Aguila; Caty Carrera; Elena Muiño; Natalia Cullell; Jara Cárcel-Márquez; Cristina Gallego-Fabrega; Jonathan González-Sánchez; Alejandro Bustamante; Pilar Delgado; Laura Ibañez; Laura Heitsch; Jerzy Krupinski; Joan Montaner; Joan Martí-Fàbregas; Carlos Cruchaga; Jin-Moo Lee; Israel Fernandez-Cadenas Journal: J Stroke Date: 2019-09-30 Impact factor: 6.967
Authors: Bahman Yousefi; Sarvin Sanaie; Ali A Ghamari; Hassan Soleimanpour; Ansar Karimian; Ata Mahmoodpoor Journal: Indian J Crit Care Med Date: 2020-01