Red blood cell distribution width and neutrophil to lymphocyte ratio are associated with outcomes of adult subarachnoid haemorrhage patients admitted to intensive care unit

Huang, Yuan-Lan; Han, Ze‐Guang; Hu, Zhide

doi:10.1177/0004563216686623

Cited by 30 publications

(27 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ultimately, 31 studies with 3,487,896 patients were included in the analysis according to the inclusion and exclusion criteria (Figure 1). The characteristics of the included studies can be seen in Table 1 (4, 5, 9–11, 13, 21–27, 29–44).…”

Section: Resultsmentioning

confidence: 99%

Baseline Red Blood Cell Distribution Width as a Predictor of Stroke Occurrence and Outcome: A Comprehensive Meta-Analysis of 31 Studies

et al. 2019

View full text Add to dashboard Cite

Background: Red blood cell distribution width (RDW) may be a potential biomarker of inflammation in patients with stroke. Elevated RDW is associated with higher incidence of stroke, unfavorable functional outcome, and increased mortality, although results are inconsistent in the reported literature. This study aims to evaluate the predictive power of RDW regarding stroke occurrence and outcome.Methods: A thorough literature search was conducted utilizing the PubMed Central (PMC) and EMBASE databases to identify studies up to May 2019. Data from these studies were pooled, and combined odds ratios/risk ratios (ORs/RRs) were estimated for the risk of stroke, functional outcome, and mortality. A subgroup analysis was also performed to explore heterogeneity in terms of population status, demographic factors (age, gender distribution, and country), and vascular risk factors (hypertension, diabetes mellitus, and current smoking).Results: A total of 31 studies with 3,487,896 patients were included in the analysis. Elevated RDW was found to be a risk factor in ischemic stroke (OR/RR 1.528; 95% confidence interval [CI] = 1.372–1.703), whereas combined OR in subarachnoid hemorrhage (SAH) was not statistically significant (OR/RR 1.835; 95% CI = 0.888–3.792). Elevated RDW posed increased risk in populations with conventionally higher risk of stroke, such as atrial fibrillation (AF) (OR/RR 1.292; 95% CI = 1.107–1.508) and diabetes mellitus (OR/RR 2.101; 95% CI = 1.488–2.968), and in community cohorts (OR/RR 1.245; 95% CI = 1.216–1.275). In addition, higher RDW was associated with unfavorable functional outcome, either at discharge (OR/RR 1.220; 95% CI = 1.070–1.39) or at 90 days (OR/RR 1.277; 95% CI = 1.155–1.413). Higher mortality was found in patients with increased RDW (OR/RR 1.278; 95% CI = 1.221–1.337), independent of demographic factors (age, gender distribution, and country).Conclusions: Baseline RDW should be integrated into clinical practice as a predictor of ischemic stroke occurrence and outcome. Future studies should also explore the dynamic change of RDW in post-stroke patients to evaluate the clinical significance of RDW and its impact on the inflammatory state of ischemic stroke.

show abstract

Section: Resultsmentioning

confidence: 99%

Baseline Red Blood Cell Distribution Width as a Predictor of Stroke Occurrence and Outcome: A Comprehensive Meta-Analysis of 31 Studies

et al. 2019

View full text Add to dashboard Cite

show abstract

“…116 In SAH, only two retrospective studies examined NLR and found it to be associated with DCI, in-hospital death and one-year mortality. 117…”

Section: Peripheral Immune System Response In Hemorrhagic Stroke Outcmentioning

confidence: 99%

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Saand

Chen

et al. 2019

J Cereb Blood Flow Metab

125

132

View full text Add to dashboard Cite

Growing evidences suggest that stroke is a systemic disease affecting many organ systems beyond the brain. Stroke-related systemic inflammatory response and immune dysregulations may play an important role in brain injury, recovery, and stroke outcome. The two main phenomena in stroke-related peripheral immune dysregulations are systemic inflammation and post-stroke immunosuppression. There is emerging evidence suggesting that the spleen contracts following ischemic stroke, activates peripheral immune response and this may further potentiate brain injury. Whether similar brain–immune crosstalk occurs in hemorrhagic strokes such as intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) is not established. In this review, we systematically examined animal and human evidence to date on peripheral immune responses associated with hemorrhagic strokes. Specifically, we reviewed the impact of clinical systemic inflammatory response syndrome (SIRS), inflammation- and immune-associated biomarkers, the brain–spleen interaction, and cellular mediators of peripheral immune responses to ICH and SAH including regulatory T cells (Tregs). While there is growing data suggesting that peripheral immune dysregulation following hemorrhagic strokes may be important in brain injury pathogenesis and outcome, details of this brain-immune system cross-talk remain insufficiently understood. This is an important unmet scientific need that may lead to novel therapeutic strategies in this highly morbid condition.

show abstract

“…Similarly, the neutrophil-to-lymphocyte ratio (NLR) is an inflammatory parameter that can be easily calculated from routinely available hematology parameters [21]. Similar to RDW, NLR has been found to be a prognostic factor or diagnostic marker in various diseases, such as pregnancy-related disorders [22], thyroiditis [23], cancers [24,25], and cardiovascular diseases [26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Red Blood Cell Distribution Width, Neutrophil-to-Lymphocyte Ratio, and In-Hospital Mortality in Dyspneic Patients Admitted to the Emergency Department

2020

Disease Markers

Self Cite

View full text Add to dashboard Cite

Red blood cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) have shown a prognostic value in various clinical settings. We aimed to investigate the association between RDW, NLR, and in-hospital mortality in patients with dyspnea. In this retrospective study with the Medical Information Mart for Intensive Care III database (version 1.4), adult patients who came to the emergency department with dyspnea were included. Patients’ comorbidities, hematological parameters within the first 48 hours after admission to the emergency department, and in-hospital mortality were extracted. The relationships between RDW, NLR, and in-hospital mortality were analyzed with the receiver operating characteristic (ROC) curve analysis and multivariate logistic regression model. We found that hospital survivors had significantly lower NLR than those who died. However, RDW was not significantly increased in patients who died during the hospitalization. The area under the ROC curve of NLR for predicting in-hospital mortality was 0.62. On multivariate analysis, NLR was not independently associated with in-hospital mortality. On further analysis, lymphocyte percentage was independently associated with in-hospital mortality, with an odds ratio of 0.56. Therefore, we concluded that RDW and NLR are not reliable parameters to predict in-hospital mortality in critically ill patients admitted to the emergency department with dyspnea.

show abstract

Red blood cell distribution width and neutrophil to lymphocyte ratio are associated with outcomes of adult subarachnoid haemorrhage patients admitted to intensive care unit

Cited by 30 publications

References 47 publications

Baseline Red Blood Cell Distribution Width as a Predictor of Stroke Occurrence and Outcome: A Comprehensive Meta-Analysis of 31 Studies

Baseline Red Blood Cell Distribution Width as a Predictor of Stroke Occurrence and Outcome: A Comprehensive Meta-Analysis of 31 Studies

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Red Blood Cell Distribution Width, Neutrophil-to-Lymphocyte Ratio, and In-Hospital Mortality in Dyspneic Patients Admitted to the Emergency Department

Contact Info

Product

Resources

About