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Thromb Haemost 2012; 108(02): 349-356
DOI: 10.1160/TH12-03-0165
Platelets and Blood Cells
Schattauer GmbH

Red blood cell distribution width is associated with poor clinical outcome in acute cerebral infarction

Jinkwon Kim
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
,
Young Dae Kim
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
,
Tae-Jin Song
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
,
Ji Hye Park
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
,
Hye Sun Lee
2   Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
,
Chung Mo Nam
2   Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
,
Hyo Suk Nam
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
,
Ji Hoe Heo
1   Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
› Author Affiliations Financial support: This work was supported by a grant from the Korea Healthcare Technology Research and Development Project, Ministry for Health, Welfare, and Family Affairs, Republic of Korea (A102065).
Further Information

Publication History

Received: 13 March 2012

Accepted after minor revision: 14 May 2012

Publication Date:
25 November 2017 (online)

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Summary

Increased red blood cell distribution width (RDW), which is a marker of anisocytosis, is associated with mortality and cardiovascular events in the general population and in patients with heart failure or coronary heart disease. We investigated whether RDW in acute cerebral infarction is predictive of functional outcome and mortality. A total of 847 consecutive patients with first-ever acute cerebral infarction who presented to the emergency department within seven days of symptom onset were enrolled in this study. We investigated the association of RDW with poor functional outcome (modified Rankin Scale >2) and all-cause mortality at three months, as well as survival time for one year after stroke onset. Multivariate logistic regression revealed that higher RDW was independently associated with poor functional outcome (adjusted odds ratio [OR], 1.222 per 1% increment in RDW, 95% confidence interval [CI] 1.059–1.409, p=0.006) and all-cause death (adjusted OR, 1.395 per 1% increment in RDW, 95% CI 1.168–1.665, p<0.001) at three months after stroke onset. RDW was an independent predictor of survival in multivariate Cox-proportional regression model (adjusted hazard ratio, 1.328 per 1% increment in RDW, 95%CI 1.178–1.498, p<0.001). The addition of RDW to a survival model significantly increased predictability for survival across the entire follow-up period (weighted average of the area-under the curves, 0.858 vs. 0.841, p<0.05). In conclusion, higher RDW measured in cases of acute stage cerebral infarction was associated with poor functional outcome and mortality. RDW may be used as a biomarker for the prediction of long-term outcomes in patients with acute cerebral infarction.

Keywords

Cerebrovascular disease - stroke - mortality - red blood cell distribution width (RDW)

 

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