Predicting the One-Year Prognosis and Mortality of Patients with Acute | CIA – Dove Medical Press

Wei-Yi Ye,1,2 Jia Li,2 Xiang Li,2 Xue-Zhi Yang,2 Yi-Yun Weng,2 Wei-Wei Xiang,3 Ou Zhang,2 Bo-Xi Ke,4,* Xu Zhang2,*

1Shaoxing Peoples Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang, Peoples Republic of China; 2Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Peoples Republic of China; 3School of Mental Health, Wenzhou Medical University, Wenzhou, Peoples Republic of China; 4Taizhou Central Hospital (Taizhou University Hospital), Zhejiang, Peoples Republic of China

*These authors contributed equally to this work

Correspondence: Xu Zhang Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Peoples Republic of China Tel +86 577 5557 9372 Fax +86 577 5557 9318 Email 1102805261@qq.com Bo-Xi Ke Taizhou Central Hospital (Taizhou University Hospital), Zhejiang 318000, Peoples Republic of China Tel +86 139 5769 8220 Email keboxi@163.com

Purpose: Red blood cell (RBC) distribution width (RDW) is known to reflect the heterogeneity of RBC volume, which may be associated with cardiovascular events or mortality after myocardial infarction. However, the association between RDW and stroke, especially regarding endpoints such as death, remains ambiguous. This study aimed to explore the prognostic value of RDW and its effect on mortality among patients with acute ischemic stroke (AIS) undergoing intravenous thrombolysis (IVT) after one year. Patients and Methods: We retrospectively reviewed patients with AIS treated with IVT between January 2016 and March 2018. We grouped the patients according to modified ranking scale (MRS) scores as follows:0 2, favorable functional outcome group; and 3 6, unfavorable functional outcome. Predictors were determined using multivariate logistic regression (MVLR). The area under receiver-operating characteristic curve (AUC) was used to evaluate the predictive capability of variables. Furthermore, the Cox proportional hazard model was used to assess the contribution of risk factors to the outcome of death at one year later. Results: MVLR analysis showed that RDW (odds ratio [OR], 1.179; 95% confidence interval [CI], 0.900 1.545; p = 0.232) was not an independent predictor of unfavorable functional outcome, but it (OR 1.371; 95% CI 1.109 1.696; p = 0.004) was an independent biomarker for all-cause mortality. The optimal RDW cut-off value to predict mortality was 14.65% (sensitivity: 42%, specificity: 88.3%, AUC: 0.649, p < 0.001). Furthermore, higher RDW (hazard ratio, 2.860; 95% CI, 1.724 4.745; p < 0.001) indicated a greater risk of death. Conclusion: The baseline RDW is a potential predictor of mortality in patients with AIS undergoing IVT, but RDW might not be associated with worse survival function among stroke survivors, which will help us to improve treatments and the management of patients with AIS.

Keywords: red blood cells, death, inflammatory, cerebrovascular accident, fibrinolytic therapy, predictor

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Predicting the One-Year Prognosis and Mortality of Patients with Acute | CIA - Dove Medical Press