Value of red blood cell distribution width in predicting early poor neurologic improvement after intravenous thrombolysis in patients with ischemic stroke
10.12092/j.issn.1009-2501.2023.03.009
- Author:
Zhiyong WU
1
;
Bingrong LIU
1
;
Bin LI
2
;
Rui TANG
3
Author Information
1. Deparment of Neurology, Ma'anshan General Hospital of Ranger-Duree Healthcare, Driectly Affiliated to Clinical College of Anhui Medical University
2. Department of Neurology, Anhui NO.2 Provincial People's Hospital
3. Department of Neurocritical Care Unit, The First Affiliated Hospital of University of Science and Technology of China
- Publication Type:Journal Article
- Keywords:
acute cerebral infarction;
early neurologic improvement;
intravenous thrombolysis;
red blood cell distribution width
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2023;28(3):307-314
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To explore the predictive value of red blood cell distribution width (RDW) in early poor neurologic improvement after intravenous thrombolysis in acute ischemic stroke (AIS). METHODS: A total of 102 patients with acute ischemic stroke who received intravenous thromblysis with alteplase within 4.5 hours of onset were analyzed retrospectively. RDW level was measured before thrombolysis. According to the percentage change in NIHSS at 24 hours, the patients were divided into two groups: good neurological improvement (≥ 30%) group (n=53) and poor neurological improvement (<30%) group (n=49). The univariate and multivariate Logistic regression analysis were used to investigate whether RDW level is an independent factor affecting patients' neurological improvement. The receiver operating characteristic (ROC) curve was used to analyze the cut-off value of RDW to predict poor early neurological improvement after thrombolysis. RESULTS: Compared with the good neurological improvement group, higher proportion of atrial fibrillation (24.5% vs. 9.4%, P= 0.042), diabetes mellitus (57.1% vs. 30.2%, P= 0.006), hemorrhagic transformation (10.2% vs. 0%, P=0.023) in the poor neurological improvement group. The level of RDW in poor neurological improvement group was significantly higher than that in good neurological improved group(14.09±0.77) vs. (13.31±0.63), P=0.000. Logistic regression analysis showed that elevated RDW (OR=4.614, 95%CI: 2.263-9.408, P=0.000) and history of diabetes mellitus (OR=2.606, 95%CI: 1.034-6.573, P=0.042) were independently associated with early poor neurological improvement. The ROC curve analysis showed that the optimal cut-off value of RDW to predict poor early neurological improvement after thrombolysis was 13.56% (AUC=0.782, 95%CI: 0.690-0.874; sensitivity 76%; specificity 74%). CONCLUSION: Elevated RDW is of a certain value in predicting the poor early neurological improvement of AIS patients after thrombolysis.
