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Research Paper|Volume 13, Issue 16|pp 20762—20773

High red blood cell distribution width levels could increase the risk of hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients

Hongyang Fan1,2, Xiaojie Liu2, Sai Li2, Peipei Liu2, Yuxia Song3, Haili Wang3, Xiaojia Tang3, Yuhan Luo3, Jun Li2, Yan Zhu2, Yingzhu Chen2
  • 1The Neurology Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang 222002, Jiangsu, China
  • 2Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou 225001, Jiangsu, China
  • 3Dalian Medical University, Dalian 116000, Liaoning, China
* Equal contribution
Received: July 16, 2020Accepted: May 12, 2021Published: August 27, 2021
https://doi.org/10.18632/aging.203465

Copyright: © 2021 Fan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The association between the red blood cell distribution width (RDW) and hemorrhagic transformation (HT) after thrombolysis in acute ischemic stroke patients remains inconclusive. Our study aimed to assess whether high RDW levels are associated with the occurrence of HT after thrombolysis. Data were consecutively collected and retrospectively analyzed for stroke patients treated with thrombolysis between 1 January 2017 and 31 December 2019. The primary outcomes were the occurrence of HT and symptomatic HT. Among the 286 patients enrolled, 36 (12.6%) developed HT and15 (5.2%) were classified as symptomatic HT. Patients with high RDW levels were associated with a higher percentage of HT and symptomatic HT (P<0.05). The RDW levels in the HT and symptomatic HT groups were also greater compared with the no-HT group (P<0.001). Multivariable logistic regression analysis revealed that high RDW levels were independently associated with an increased risk of HT (adjusted odds ratio 2.5, 95 % CI, 1.74–3.83 P < 0.001). In conclusion, we found that high RDW levels may be an independent predictor of HT in stroke patients after thrombolysis.