Red Blood Cell Distribution Width is Associated with Poor Clinical Outcome After Subarachnoid Hemorrhage: A Pilot...

Area of Science:

• Neurology
• Hematology
• Critical Care Medicine

Background:

• Red cell distribution width (RDW) is a known predictor of poor outcomes in inflammatory and thrombotic conditions.
• Subarachnoid hemorrhage (SAH) presents as a complex inflammatory and thrombotic state.
• Existing biomarkers for SAH outcomes are numerous, necessitating further investigation into predictive markers.

Purpose of the Study:

• To investigate the association between red cell distribution width (RDW) and patient outcomes following subarachnoid hemorrhage (SAH).
• To determine if RDW can serve as a predictive biomarker for poor outcomes in SAH patients.

Main Methods:

• Prospective observational study of 40 patients with moderate-to-severe SAH.
• Serial measurements of complete blood count (CBC) including RDW, ESR, hs-CRP, D-dimer, and fibrinogen on post-bleed days 1, 3, 5, 7, and 10.
• Poor outcome defined as modified Rankin score (mRS) of 3-6 at 90 days.

Main Results:

• Higher serial RDW levels were significantly associated with poor outcomes (p=0.046).
• Maximum RDW (OR 2.3, p=0.014) and maximum WBC count (OR 1.29, p=0.018) independently predicted poor outcomes.
• A predictive model including RDW and fibrinogen, adjusted for age and Hunt and Hess grade, identified RDW, fibrinogen, and high-grade SAH as significant predictors of poor outcome.

Conclusions:

• Elevated RDW is significantly associated with poor outcomes in patients with SAH.
• RDW demonstrates potential as a valuable and accessible biomarker for predicting outcomes after SAH.