Association between red cell distribution width-to-lymphocyte ratio and 30-day mortality in patients with ischemic stroke: a retrospective cohort study.

IF 2.6 4区 医学 Q2 HEMATOLOGY Thrombosis Journal Pub Date : 2024-12-18 DOI:10.1186/s12959-024-00671-y
Liqiang Chen, Jianchao Li, Shuang Wang, Lizhen Zhao, Shuai Hu
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Abstract

Objectives: Ischaemic stroke (IS) has become a major health problem globally as it is one of the leading causes of long-term disability and death. This study aimed to evaluate the association between red cell distribution width (RDW) to lymphocyte (LYM) ratio (RLR) and 30-day mortality risk in patients with IS.

Methods: The present study employed a retrospectively cohort study design with the adult data extracted from the Medical Information Mart for Intensive Care (MIMIC-III, MIMIC-IV) databases between 2001 and 2019. The RLR was measured using RDW and LYM. Confounders were adjusted in Cox proportional hazards model. The outcome was 30-day mortality. Univariable and multivariable Cox proportional hazards models were establised. A further analysis was conducted on the basis of subgroup stratification by heart failure (HF) (yes or no), atrial fibrillation or flutter (yes or no), hypertension (yes or no), dyslipidemia (yes or no), sepsis (yes or no), and age (≥ 65 years and < 65 years).

Results: In this study, 1,127 adult patients with IS were finally identified. Among them,818 patients survived (the survival group) and 309 patients died (the death group). The mean age was older in individuals from the death group than those from the survival group (70.19 years vs. 64.56 years). The elevated levels of RLR were linked to an increased risk of mortality within 30 days in patients with IS, with an HR of 1.70 (95% CI: 1.34-2.17). Subgroup analyses showed that high RLR levels was a significant risk factor for mortality at 30 days particularly in IS patients aged ≥ 65 years, HF, no atrial fibrillation or flutter, no hypertension, no dyslipidemia, and no sepsis.

Conclusion: Our study shows that high levels of RLR were associated with an increased risk of 30-day mortality in patients with IS, providing additional prognostic information for the treatment and supportive care of these patients.

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缺血性脑卒中患者红细胞分布宽度与淋巴细胞比值与30天死亡率之间的关系:一项回顾性队列研究
目的:缺血性中风(IS)已成为全球主要的健康问题,因为它是长期残疾和死亡的主要原因之一。本研究旨在评估IS患者红细胞分布宽度(RDW)与淋巴细胞(LYM)比值(RLR)与30天死亡风险之间的关系。方法:本研究采用回顾性队列研究设计,从2001年至2019年重症监护医学信息市场(MIMIC-III, MIMIC-IV)数据库中提取成人数据。RLR采用RDW和LYM测量。在Cox比例风险模型中调整混杂因素。结果是30天死亡率。建立单变量和多变量Cox比例风险模型。在心衰(HF)(是或否)、心房颤动或扑动(是或否)、高血压(是或否)、血脂异常(是或否)、败血症(是或否)、年龄(≥65岁)亚组分层的基础上进行进一步分析。结果:在本研究中,最终确定了1127名成年IS患者。其中存活818例(生存组),死亡309例(死亡组)。死亡组患者的平均年龄大于生存组患者(70.19岁vs. 64.56岁)。RLR水平升高与IS患者30天内死亡风险增加有关,相对危险度为1.70 (95% CI: 1.34-2.17)。亚组分析显示,高RLR水平是30天死亡率的重要危险因素,特别是年龄≥65岁、HF、无心房颤动或扑动、无高血压、无血脂异常和无败血症的IS患者。结论:我们的研究表明,高水平的RLR与IS患者30天死亡风险增加有关,为这些患者的治疗和支持性护理提供了额外的预后信息。
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来源期刊
Thrombosis Journal
Thrombosis Journal Medicine-Hematology
CiteScore
3.80
自引率
3.20%
发文量
69
审稿时长
16 weeks
期刊介绍: Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.
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