Correlation between the red blood cell distribution width and prognosis in elderly patients with cerebral infarction and severe hemiplegia / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatethecorrelationbetweentheredbloodcelldistributionwidth (RDW)and in-hospital prognosis in elderly patients with cerebral infarction and severe hemiplegia. Methods Atotalof209consecutiveelderlypatientswithcerebralinfarctionandhemiplegiadiagnosedat the Emergency Department,Central Hospital of Jiading District in Shanghai from January 2012 to December 2013 were enrolled retrospectively. All patients were divided into an L-RDW group (n=73 ),an M-RDW group (n=56),and an H-RDW group (n=80)according to the RDW trisection level. A single factor analysis of variance was used to compare the differences of clinical data,laboratory indexes,and mortality during hospitalization among the three groups. The patients were redivided into either a survival group (n=170)or a death group (n=39)according to their clinical outcomes. Its differences of RDW levels in the acute phase were compared. Logistic regression analysis was used to analyze the independence risk factors for the death of patients,and the risk ratio (OR)was calculated. Spearman correlation analysis was used to analyzeRDWandtheNationalInstitutesofHealthStrokeScale(NIHSS)scores.Results Themortality of the M-RDW group was significantly lower than that of the L-RDW and the H-RDW groups (1. 8%[n=1] vs. 12. 3%[n=9]and 36. 2%[n=29],all P<0. 01). the RDW level of the death group was significantly higher than that of the survival group (14.2 [13.3,15.1]vs.12.5 [11. 9,13. 5];P =0. 002). The H-RDW level (OR,12. 164,95%CI 2.544-58.181,P=0.002)and the NIHSS score (OR,1. 136, 95%CI 1. 056-1. 221,P=0. 001)were the independence risk factors for the death of the elderly patients with severe hemiplegia cerebral infarction;the RDW level was positively correlated with the NIHSSscore(r=0.167,P=0.016).Conclusion ThemortalityofdifferentRDWlevelsinelderly patients with cerebral infarction and severe hemiplegia showed aU shape. The mortality of the H-RDW is the highest. The RDW level has an important reference value for identifying the prognosis in elderly patients with cerebral infarction and severe hemiplegia.