Value of red blood cell distribution width in predicting early poor neurologic improvement after intravenous thrombolysis in patients with ischemic stroke

doi:10.12092/j.issn.1009-2501.2023.03.009

Abstract

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). METH-ODS: 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 in-to two groups: good neurological improvement (≥ 30%) group (n=53) and poor neurological improve-ment (<30%) group (n=49). The univariate and mul-tivariate Logistic regression analysis were used to investigate whether RDW level is an independent factor affecting patients' neurological improve-ment. The receiver operating characteristic (ROC) curve was used to analyze the cut-off value of RDW to predict poor early neurological improvement af-ter thrombolysis. RESULTS: Compared with the good neurological improvement group, higher pro-portion 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 im-provement 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 anal-ysis showed that elevated RDW (OR=4.614, 95%CI: 2.263-9.408, P=0.000) and history of diabetes melli-tus (OR=2.606, 95%CI: 1.034-6.573, P=0.042) were independently associated with early poor neurolog-ical improvement. The ROC curve analysis showed that the optimal cut-off value of RDW to predict poor early neurological improvement after throm-bolysis was 13.56% (AUC=0.782, 95%CI: 0.690-0.874; sensitivity 76%; specificity 74%). CONCLU-SION: Elevated RDW is of a certain value in predict-ing the poor early neurological improvement of AIS patients after thrombolysis.

Key words: red blood cell distribution width, acute cerebral infarction, intravenous thrombolysis, early neurologic improvement

CLC Number:

R743.32

WU Zhiyong, LIU Bingrong, LI Bin, TANG Rui. Value of red blood cell distribution width in predicting early poor neurologic improvement after intravenous thrombolysis in patients with ischemic stroke [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(3): 307-314.

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