Elevated red blood cell distribution width predicts mortality in persons with known stroke

Area of Science:

• Hematology
• Cardiovascular Medicine
• Epidemiology

Background:

• Red cell distribution width (RDW) is a standard complete blood count parameter.
• RDW is emerging as a predictor of outcomes in cardiovascular disease.
• The prognostic role of RDW in stroke patients, particularly concerning mortality, is not well understood.

Purpose of the Study:

• To assess the association between RDW and stroke occurrence.
• To investigate the effect of RDW on mortality among individuals with stroke.

Main Methods:

• Analysis of data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of US adults.
• Inclusion of 480 individuals aged 25 years and older with a baseline history of stroke, followed up through 2000.
• Utilization of proportional hazard regression (Cox) to determine the independent relationship between RDW and mortality, adjusting for confounders.

Main Results:

• Mean RDW was significantly higher in individuals with stroke compared to those without (13.7% vs. 13.2%, p<0.001).
• Baseline RDW was higher in stroke patients who died compared to those who survived (13.9% vs. 13.4%, p<0.001).
• Elevated RDW (fourth vs. first quartile) was associated with a higher likelihood of stroke (OR 1.71) and independently predicted cardiovascular deaths (HR=2.38) and all-cause deaths (HR=2.0) in stroke patients.

Conclusions:

• Elevated RDW is associated with stroke occurrence.
• Higher RDW levels strongly predict both cardiovascular and all-cause mortality in individuals with a known history of stroke.