Title:Combined Role of Inflammatory Biomarkers and Red Blood Cell Distribution
Width in Predicting In-hospital Outcomes of Acute Ischemic Stroke Patients
Undergoing Thrombolysis
Volume: 20
Issue: 2
Author(s): Yi Wang, Yafang Zhu, Xiaohong Wang, Chongke Zhong, Yan Qin, Yongrong Sun, Yongjun Cao, Xia Zhang*Dongqin Chen*
Affiliation:
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of
Soochow University, Suzhou, China
- Department of Neurology and Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of
Soochow University, Suzhou, China
Keywords:
Acute ischemic stroke, white blood cell, C-reactive protein, red blood cell distribution width, thrombolysis, combined effect.
Abstract:
Background: To investigate the combined effect of red blood cell distribution width
(RDW) and inflammatory biomarkers on in-hospital outcomes of acute ischemic stroke(AIS) patients
with thrombolysis.
Methods: 417 AIS patients with thrombolysis were included. The participants were divided into
four groups according to the cut-off of white blood cell (WBC) or C reactive protein (CRP) and
RDW: LWLR, LWHR, HWLR, and HWHR; or LCLR, LCHR, HCLR, and HCHR (L-low, Hhigh,
W-WBC, C-CRP, R-RDW). Logistic regression models were used to calculate the odds ratios
(ORs) and 95% confidence intervals (CIs) of in-hospital pneumonia and functional outcome
across the four subgroups.
Results: Patients with higher RDW and inflammatory biomarkers levels have the highest risk of
in-hospital outcomes. Compared with patients in the LWLR group, the ORs (95% CIs) of those in
the HWHR group were 12.16 (4.21-35.14) and 9.31 (3.19-27.17) for in-hospital pneumonia and
functional outcome. The ORs (95% CIs) of those in the HCHR group were 6.93 (2.70-17.78) and
3.38 (1.10-10.39) for in-hospital pneumonia and functional outcome, compared with patients in the
LCLR group. Simultaneously adding RDW and WBC or CRP to the basic model with established
risk factors significantly improved risk discrimination and reclassification for pneumonia and functional
outcome (all p <0.05).
Conclusions: Combined RDW and inflammatory biomarkers within 4.5 hours had a better predictive
power for in-hospital outcomes of AIS patients with thrombolysis.
