Elevated Red Blood Cell Distribution Width Levels at Admission Predicts Depression After Acute Ischemic Stroke: A 3-Month Follow-Up Study

Abstract

Purpose Red blood cell distribution width (RDW) is closely related to inflammatory-related disease markers. The present study aimed to investigate the association between the red blood cell distribution width (RDW) and post-stroke depression (PSD). Patients and Methods A total of 414 patients with acute ischemic stroke (AIS) admitted to our hospital from June 2018 to July 2021 were consecutively enrolled and received 3 months’ follow-up. According to the 17-item Hamilton Depression Scale (HAMD) assessment, they were divided into PSD group and non-PSD group. Diagnosis of PSD was made in accordance with DSM-IV. RDW was recorded within 24 hours of admission. Results Among the included 414 patients, 95 (22.95%) patients were diagnosed as having PSD at 3 months after stroke. The results showed significantly higher level of RDW in patients with depression (13.69 (IQR13.24–13.88) vs. 13.56 (IQR 12.67–13.77), P<0.001) at admission than patients without depression. After adjustment for potential confounding factors, the odds ratio of PSD was 5.707 (95% CI, 2.717–11.989) for the highest tertile of RDW compared with the lowest tertile. Moreover, based on the receiver operating characteristic (ROC) curve, the optimal cutoff of RDW levels as an indicator for the prediction of PSD was projected as 13.01, which yielded a sensitivity of 83% and a specificity of 41.0%, with an area under the curve (AUC) of 0.643 (95% CI, 0.585–0.701; P = 0.012). Conclusion Higher RDW levels at admission were found to be correlated with PSD 3 months after stroke.

The relationship between red blood cell distribution width at admission and post-stroke fatigue in the acute phase of acute ischemic stroke

“…What is more, high RDW levels may increase the risk of hemorrhagic transformation after intravenous thrombolysis in AIS patients ( 31 ). Nowadays, the levels of RDW were found to be linked to post-stroke depression ( 16 ), another common emotional complication after the onset of AIS. Although there are several studies focusing on the relationship between RDW and cerebrovascular disease, this study is the first prospective study that explore the role of RDW on PSF, and may assist neurologists with managing AIS patients.…”

“…The levels of RDW might be associated with long-term all-cause mortality in the patients with acute myocardial infarction ( 15 ). Moreover, one recent study, which is carried out by Li Y et al, have found that elevated levels of RDW at admission may be able to predict depression after the onset of AIS ( 16 ).…”

Elevated red blood cell distribution width levels predict depression after intracerebral hemorrhage: A 3-month follow-up study

“…Post-ICH depression presented a relationship with the worsening disability in the late stages, which was irrelevant to the initial bleeding severity ( 7 ). Additionally, higher-level RDW could independently predict the occurrence of depression after acute cerebral ischemia ( 23 , 24 ) and predicted the risk of coronary artery disease for patients with major depression disorder ( 25 ). Elevated RDW is correlated with the occurrence of stroke and strongly predicts both cardiovascular and all-cause mortalities in patients with known strokes ( 26 ).…”