Highlights
- •RDW was found to be a prognostic marker in several conditions
- •Higher RDW is associated with decreased survival after thrombolysis in ischemic stroke
- •The predictive role of RDW is not dependent on stroke severity
- •The predictive role of RDW is dependent on age and early post-stroke infection
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.
Keywords
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Article info
Publication history
Published online: February 06, 2018
Accepted:
February 6,
2018
Received in revised form:
January 28,
2018
Received:
October 4,
2017
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
