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首页> 外文期刊>Journal of Clinical Medicine Research >Does Red Cell Distribution Width Predict Outcome in Traumatic Brain Injury: Comparison to Corticosteroid Randomization After Significant Head Injury
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Does Red Cell Distribution Width Predict Outcome in Traumatic Brain Injury: Comparison to Corticosteroid Randomization After Significant Head Injury

机译：红细胞分布宽度是否可预测颅脑外伤的结果：重大颅脑损伤后与皮质类固醇随机分配的比较

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Background: Traumatic brain injury (TBI) is a leading cause of death and disability. The role of red cell distribution width (RDW) as a prognostic biomarker for outcome in TBI patients is unknown. Based on the corticosteroid randomization after significant head injury (CRASH) trial database, a prognosis calculator (CRASH) has been developed for outcome prediction in TBI. The objectives of this study are to investigate the association between RDW on day 1 of TBI and outcome, and to compare outcome prediction from RDW to that from CRASH.Methods: We performed a retrospective review of patients with TBI and a Glasgow coma scale (GCS) score of 14 or less. Day 1 RDW and CRASH data were extracted. CRASH was calculated for each patient. Outcome was defined as mortality at 14 days and GOS at 6 months, with poor outcome defined as GOS of 1 - 3. Patients were stratified according to RDW values into six groups, and according to CRASH values into six groups.Results: A total of 416 patients with TBI were included, with 339 survivors (S) and 77 non-survivors (NS). Compared to survivors, non-survivors were of similar age in years (58 ± 23 vs. 58 ± 23, P = 1.0), had lower GCS scores (5 ± 3 vs. 12 ± 3, P = 0.0001), similar RDW (14.0 ± 1.2 vs. 13.9 ± 1.5, P = 0.6), and higher CRASH values (68 ± 26 vs. 24 ± 22, P = 0.0001). Estimating the receiver-operating characteristic (ROC) area under the curve (AUC) showed that CRASH was a significantly better predictor of mortality compared to RDW (AUC = 0.91 ± 0.01 for CRASH compared to 0.66 ± 0.03 for RDW; P < 0.0001). In addition, CRASH was a better predictor of neurologic outcome compared to RDW (AUC = 0.85 ± 0.02 for CRASH compared to 0.76 ± 0.03 for RDW; P = 0.005).Conclusions: CRASH calculator was a strong predictor of mortality in patients with TBI. RDW on day 1 did not differ between survivors and non-survivors, and was a poor predictor of mortality. Both RDW on day 1 and CRASH calculator are good predictors of 6-month outcome in TBI patients, although CRASH calculator remains a better predictor.J Clin Med Res. 2018;10(1):9-12doi: https://doi.org/10.14740/jocmr3173w
机译：背景：颅脑外伤（TBI）是导致死亡和残疾的主要原因。红细胞分布宽度（RDW）作为TBI患者预后的生物标志物的作用尚不清楚。基于重大颅脑损伤后皮质类固醇随机分组（CRASH）试验数据库，已开发出预后计算器（CRASH）用于TBI的预后预测。这项研究的目的是调查TBI第1天的RDW与结局之间的关联，并比较RDW与CRASH的结局预测。方法：我们对TBI和格拉斯哥昏迷量表（GCS）患者进行了回顾性回顾）得分不超过14分。第1天提取RDW和CRASH数据。计算每位患者的CRASH。结果定义为14天时的死亡率和6个月时的GOS，差的结果定义为1-3的GOS。根据RDW值将患者分为6组，并按照CRASH值将患者分为6组。包括416例TBI患者，其中339名幸存者（S）和77名非幸存者（NS）。与幸存者相比，非幸存者的年龄相似（58±23 vs. 58±23，P = 1.0），GCS评分较低（5±3 vs. 12±3，P = 0.0001），RDW相似（ 14.0±1.2与13.9±1.5，P = 0.6）和更高的CRASH值（68±26与24±22，P = 0.0001）。估算曲线下的接收器操作特征（ROC）区域（AUC）表明，与RDW相比，CRASH是死亡率的更好预测指标（CRASH的AUC = 0.91±0.01，而RDW的为0.66±0.03; P <0.0001）。此外，与RDW相比，CRASH可以更好地预测神经系统结局（CRASH的AUC = 0.85±0.02，而RDW的0.76±0.03; P = 0.005）。结论：CRASH计算器是TBI患者死亡率的有力预测指标。第1天的RDW在幸存者和非幸存者之间没有差异，并且是死亡率的不良预测指标。第一天的RDW和CRASH计算器都是TBI患者6个月预后的良好预测指标，尽管CRASH计算器仍然是更好的预测指标。JClin Med Res。 2018; 10（1）：9-12doi：https://doi.org/10.14740/jocmr3173w

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