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

Peng, Meidi; Chen, Yu-Pei; Chen, Yan; Feng, Koulan; Shen, Huiyong; Huang, Hongtao; Zhao, Wei; Zou, Hua; Ji, Jianan

doi:10.3389/fneur.2022.922823

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…This is consistent with previous findings of abnormal rheological properties of red blood cells including higher shear stress, elongation, and elevation of RDW in GWI veterans [ 95 ]. An elevated RDW has been associated with fatigue in conditions such as systemic lupus erythematosus (SLE) [ 96 ] and post-stroke fatigue [ 97 ]. While the relation between RDW and fatigue is commonly related to iron deficiency and anemia [ 96 , 98 ], like in SLE we found no significant changes in hemoglobin (HGB) that would support this.…”

Section: Discussionmentioning

confidence: 99%

Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures

Sultana,

Shastry,

Kasarla

et al. 2024

Military Med Res

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Background One-third of veterans returning from the 1990–1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI. Methods Symptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups. Results GWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P < 0.03). Additional differences in natural killer (NK) cell numbers and function highlight IL-15 as a potential biomarker of GWI in the absence of PTSD symptoms. Conclusion We conclude that disentangling GWI and PTSD by defining trauma-based subgroups may aid in the identification of unique GWI biosignatures that can help to improve diagnosis and target treatment of GWI more effectively.

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Section: Discussionmentioning

confidence: 99%

Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures

Sultana,

Shastry,

Kasarla

et al. 2024

Military Med Res

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“…RDW at admission is the independent associated factor in many acute diseases. Peng et al [24] found that after the adjustment for potential confounding factors, RDW at admission remained the independent associated factor with post-stroke fatigue in the acute phase. Cai et al [25] revealed that RDW �14.45% at admission was associated with 28-day mortality in patients with ARDS using cox regression analysis, while Kaplan-Meier analysis showed patients with RDW �14.45% had a significantly lower survival rate than those with RDW <14.45%.…”

Section: Plos Onementioning

confidence: 99%

“…RDW: red cell distribution width, AUC: areas under curve, CI: confidence interval, NPV: negative predictive value, PPV: positive predictive value, SOFA: sequential organ failure assessment, RDW T0: RDW value within the 24 h after ICU admission, RDW T1: RDW value at24 to 48 h after ICU admission, RDW changes: RDW T1 minus RDW T0 Adjusted for age, ethnicity, type of ICU at first hospitalization, ventilation time, vasopressor use, RRT, antibiotics use, AKI, temperature, RR, weight, FIO2, BUN, lactate, Cr, INR, chloride, PTT, and CCI.…”

mentioning

confidence: 99%

Association of red cell distribution width and its changes with the 30-day mortality in patients with acute respiratory failure: An analysis of MIMIC-IV database

Shi,

Chen

et al. 2023

PLoS ONE

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Background Acute respiratory failure (ARF) is a common disease in the intensive care units (ICUs) with high risk of mortality. The red cell distribution width (RDW) is one of baseline ICU indicators which can be easily available, and has been used in the long-term prognostic analyses of diseases. However, no studies have explored the role of baseline RDW and its change during hospitalization in in-hospital mortality in ARF. Herein, this study aims to explore the association between RDW and its changes and the 30-day mortality in ARF patients. Methods Demographic and clinical data of 7,497 patients with ARF were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database in 2012–2019 in this retrospective cohort study. Univariable and multivariable Cox regression analyses were used to explore the association between RDW and its changes and 30-day mortality with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of different baseline RDW levels were also performed. We then assessed the predictive performance of RDW changes combined with the Sequential Organ Failure Assessment (SOFA) score on 30-day mortality using receiver operator characteristic curves (ROCs) with areas under curve (AUCs). Results Totally, 2,254 (30.07%) patients died in 30 days. After adjusting for covariates, we found that high baseline RDW [HR = 1.25, 95%CI: (1.15–1.37)] and RDW changes ≥0.3% [HR = 1.12, 95%CI: (1.01–1.24)] were both related to an increased risk of 30-day mortality. In patients whose baseline RDW level ≥14.9%, RDW changes ≥0.3% was also associated with an increased risk of 30-day mortality [HR = 1.19, 95%CI: (1.05–1.35)]. Moreover, the predictive value of RDW changes combined with SOFA on 30-day mortality was a little better than that of single SOFA score, with AUCs of 0.624 vs. 0.620. Conclusion High baseline RDW level and its changes during hospitalization was relate to the increased risk of 30-day mortality in ARF, and the predictive value of RDW changes for ARF short-term mortality is still needed exploration.

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“…Recently, numerous studies have reported that a higher level of RDW was associated with adverse outcomes in patients with the first stroke [10][11][12][13][14]. For example, João Pinho et al [11] performed a single-center retrospective cohort study and found that patients in the higher quartiles of RDW presented a lower 1-year survival (p < 0.001).…”

Section: Introductionmentioning

confidence: 99%

Association between red blood cell distribution width and ischemic stroke recurrence in patients with acute ischemic stroke: a 10-years retrospective cohort analysis

Zhan

Huang

Zhou

et al. 2023

Aging

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Numerous studies have reported that a higher red blood cell distribution width (RDW) level was associated with adverse outcomes in patients with the first stroke. However, no studies have examined the association between RDW and recurrent ischemic stroke. We performed a population-based cohort data analysis from 2007 to 2017. Baseline RDW was measured in 6402 first ischemic stroke participants, who were followed for about five years on average. During 62 months of median follow-up, 205 participants (3.20%) reported a recurrence (self-reported). RDW showed a nonlinear relationship with the risk of ischemic stroke recurrence. When RDW was assessed as quartiles (quartile 1, RDW<12.4; quartile 2, 12.4 to 12.8; quartile 3,12.8 to 13.3, quartile4, RDW>13.3), compared with the reference group (quartile 1), the hazard ratios (HRs) of ischemic stroke recurrence were 1.372 (95% confidence interval [CI]=0.671-2.805, P=0.386) in quartile 2, 1.835 (95% CI=1.222-2.755, P=0.003) in quartile 3, and 1.732 (95% CI=1.114-2.561, P<0.001) in quartile 4. The trend test was significant (P<0.001). When quartiles 3 and 4 were combined, the adjusted HR of ischemic stroke recurrence was 1.439 (95% CI=1.330-1.556, P<0.001) compared with the combined quartiles 1 and 2 subgroups. This study demonstrated that elevated RDW levels were positively associated with an increased risk of recurrent ischemic stroke. RDW can provide a new perspective for initial risk assessment and identify high-risk patients early. Further research is required to confirm our results.

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

Cited by 5 publications

References 31 publications

Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures

Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures

Association of red cell distribution width and its changes with the 30-day mortality in patients with acute respiratory failure: An analysis of MIMIC-IV database

Association between red blood cell distribution width and ischemic stroke recurrence in patients with acute ischemic stroke: a 10-years retrospective cohort analysis

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