Deans' stroke musings: Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, August 19, 2024

Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke

So you discovered an association. What the fuck is the solution to prevent these unfavorable outcomes? The whole point of stroke research is to get survivors recovered! This did nothing towards that!

Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke

Xiaorui Xie¹^†

Keli He²^*^†

Yao Zhang²

Jianhua Wu²

¹Department of Neurology, Xiangya Changde Hospital, Changde, Hunan, China
²Department of Clinical Laboratory, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, Hunan, China

Aim: To explore the association of Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) with the risk of three-month unfavorable outcomes in acute ischemic stroke (AIS).

Methods: A secondary analysis was conducted based on a prospective cohort study. A total of 1,889 patients with AIS treated in South Korea from January 2010 to December 2016 were enrolled. Multivariable logistic regression was conducted to investigated the independent relationship between HRR and risk of three-month unfavorable outcomes in AIS. Fitted smoothing curves were used to determine non-linear correlations. The recursive method was employed to explore the turning point and build a two-piece linear regression model. In addition, a set of subgroup analyses were carried out to evaluate the relationship between HRR and risk of three-month unfavorable outcomes.

Results: Multivariate analysis in which potential confounders were adjusted for indicated that the risk of unfavorable outcomes was reduced by 10% for each unit increased of HRR [OR = 0.90, 95% CI: 0.84–0.96, p = 0.0024]. In addition, a non-linear relationship was observed between HRR and risk of three-month unfavorable outcomes, which had an inflection point of HRR was 10.57. The effect sizes and the confidence intervals on the left side of the inflection point were 0.83 (0.75, 0.91), p = 0.0001. On the right side of the inflection point, no association was found between HRR and the risk of three-month unfavorable outcomes.

Conclusion: This study demonstrates a negative association between HRR and risk of three-month unfavorable outcomes. The relationship between HRR and risk of three-month unfavorable outcomes is non-linear. The correlation is negative for HRR values less than 10.57. For, HRR higher than 10.57, HRR is not associated with the risk of three-month unfavorable outcomes.

Introduction

Stroke is the second leading cause of death worldwide, with acute ischemic stroke (AIS) accounting for approximately 80% of all stroke cases (1). Although it has high mortality and recurrence rates, AIS can be prevented. Early screening and implementation of effective interventions can slow down the progression of AIS and early neurological deterioration, thereby improve patient outcomes.

The ratio of hemoglobin to red blood cell distribution width (HRR) is a simple and robust biomarker of inflammation calculated from hemoglobin and red blood cell distribution width (RDW).

Several studies have demonstrated that HRR contribute to the occurrence, development and prognosis of various diseases (2–7). Qin et al. reported a relationship between HRR and mortality in AIS patients with atrial fibrillation (8). Eyiol and Ertekin have shown that a low HRR measured upon hospital admission is a valuable marker for predicting stroke mortality and determining stroke severity (9). For stroke outcome assessment, several guidelines recommend using the modified Rankin Scale (mRS) score at 3 months as the preferred endpoint due to its strengths in evaluating functional status (10). Accurate prediction of functional outcomes in stroke patients can improve treatment interventions, guide patient and family education, and optimize rehabilitation and discharge planning (11). However, to our knowledge, none study conducted statistical analysis to determine the association of HRR with the risk of three-month unfavorable outcomes in AIS patients. Hence, we conducted a secondary analysis of data from a cohort of 1906 study to generate evidence to guide future application of HRR in prognostic evaluation of AIS patients.