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首页> 外文期刊>Clinical Interventions in Aging >Predicting the One-Year Prognosis and Mortality of Patients with Acute Ischemic Stroke Using Red Blood Cell Distribution Width Before Intravenous Thrombolysis
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Predicting the One-Year Prognosis and Mortality of Patients with Acute Ischemic Stroke Using Red Blood Cell Distribution Width Before Intravenous Thrombolysis

机译：在静脉内溶栓前使用红细胞分布宽度预测急性缺血性卒中患者的一年预后和死亡率

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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.
机译：目的：已知红细胞（RBC）分布宽度（RDW）反映RBC体积的异质性，其可能与心肌梗死后的心血管事件或死亡率相关联。然而，RDW和中风之间的关联，特别是关于死亡等终点，仍然含糊不清。本研究旨在探讨RDW的预后价值及其对急性缺血性卒中（AIS）患者在一年后静脉溶栓（IVT）患者死亡率的影响。患者及方法：我们回顾性地审查了2016年1月至2018年1月间IVT治疗的AIS患者。我们根据修改的排名规模（MRS）分数如下：0-2，有利的功能结果组; 3- 6，不利的功能结果。使用多变量逻辑回归（MVLR）确定预测器。接收器操作特征曲线（AUC）下的区域用于评估变量的预测能力。此外，Cox比例危险模型用于评估危险因素在一年后对死亡结果的贡献。结果：MVLR分析表明，RDW（差距[或]，1.179; 95％置信区间[CI]，0.900-1.545; P = 0.232）不是不利的功能结果的独立预测因子，但它（或1.371; 95％ CI 1.109- 1.696; p = 0.004）是一个独立的生物标志物，用于全导致死亡率。预测死亡率的最佳RDW截止值为14.65％（敏感性：42％，特异性：88.3％，AUC：0.649，P <0.001）。此外，较高的RDW（危险比，2.860; 95％CI，1.724- 4.745; P <0.001）表明了更大的死亡风险。结论：基线RDW是患有IVT的AIS患者死亡率的潜在预测因子，但rdw可能与中风幸存者中的更糟的存活功能有关，这将有助于我们改善治疗和患者的治疗患者。

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