Admission red blood cell distribution width as a prognostic biomarker of stroke-associated pneumonia and mortality in acute ischemic stroke patients treated with thrombolysis

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-01-31 DOI:10.1016/j.jstrokecerebrovasdis.2025.108254

Sarawut Krongsut , Nat Na-Ek , Nop Khongthon

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引用次数: 0

Abstract

Background

Red blood cell distribution width (RDW) is an inflammatory marker potentially linked to stroke-associated pneumonia (SAP). This study assessed RDW's role in predicting SAP, mortality, and poor outcomes in acute ischemic stroke (AIS) patients treated with thrombolysis.

Methods

A retrospective analysis (2015–2022) of AIS patients treated with thrombolysis examined admission RDW levels. Outcomes included SAP, in-hospital (IHM) and 3-month mortality, and poor functional outcomes. Associations were analyzed using multivariable logistic regression, with predictive performance assessed via area under a receiver operating characteristic curve (AuROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) metrics.

Results

Of 345 patients, 70 (20.3 %) developed SAP. A 1-SD increase in RDW was associated with SAP (adjusted odds ratio [aOR]: 1.73; 95 % CI: 1.27–2.35), IHM (aOR: 2.14; 95 % CI: 1.43–3.21), and 3-month mortality (aOR: 1.74; 95 % CI: 1.19–2.56). The association was stronger in non-diabetics and those under 65. Although RDW did not improve the AuROC for SAP or mortality predictions, it significantly improved the NRI and IDI (p < 0.05).

Conclusions

RDW is independently associated with increased risk of SAP, IHM, and 3-month mortality in AIS patients treated with thrombolysis, suggesting its potential as a prognostic marker.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.