The link between red blood cell distribution width and 3-month prognosis in acute ischemic stroke patients: a secondary analysis of a cohort study

Few studies to date have explored correlations between red blood cell distribution width (RDW) and prognostic outcomes in acute ischemic stroke (AIS) patients, and conclusions based on the available evidence are controversial. This study was designed to better clarify the association between RDW and 3-month prognostic outcomes in AIS patients. This was a secondary analysis of a cohort study. The prospective cohort used to conduct these analyses was comprised of 1,901 AIS patients who underwent treatment in South Korea between January 2010 and December 2016. A modified Rankin Scale (mRS) value above 2 was used to define a poor 3-month prognosis. The link between RDW and poor 3-month prognostic outcomes in subjects with AIS was explored with a binary logistic regression model, with further subgroup analyses and interaction tests also being conducted. Of 1,901 individuals analyzed in this study, 1,167 (61.4%) were male, and 543 (28.6%) met the criteria for poor 3-month outcomes. Following adjustment for confounding factors, RDW was positively correlated with poor 3-month outcomes in these individuals with AIS (OR = 1.12, 95% CI; 1.03–1.23, P = 0.0120). Subgroup analyses demonstrated a consistent positive association (OR > 1.0) between elevated RDW and adverse outcomes across the majority of baseline characteristics. No interactions were observed between RDW and poor 3-month outcomes among AIS patients. These results demonstrate a positive correlation between RDW and poor 3-month prognosis among AIS patients. The findings suggest RDW may serve as a practical prognostic biomarker, warranting further validation in diverse populations.