ABSTRACT NUMBER: ESOC2026LB98 COMPARISON OF THE PROGNOSTIC VALUE OF HEMOGLOBIN TO RED CELL DISTRIBUTION WIDTH RATIO FOR FUNCTIONAL OUTCOME IN ISCHEMIC AND HEMORRHAGIC STROKE

Abstract Background and aims Hemoglobin to red cell distribution width ratio (HRR) has recently emerged as a novel biomarker with potential prognostic significance in cardiovascular diseases. However, its role in predicting functional outcome after acute stroke remains insufficiently explored. We aimed to compare the prognostic value of HRR for functional outcomes in patients with ischemic and hemorrhagic stroke. Methods We retrospectively analyzed two independent cohorts of consecutive patients hospitalized due to ischemic stroke (IS, n = 223) and intracerebral hemorrhage (ICH, n = 239). HRR was calculated from admission blood samples. Functional outcome was assessed using the modified Rankin Scale (mRS) at discharge and at 90 days, based on structured follow-up evaluations. Correlations were analyzed using Spearman’s rank test. Differences in HRR between patients with good (mRS 0–2) and poor (mRS 3–6) 90-day outcomes were assessed using the Mann–Whitney U test. Results In ischemic stroke, HRR showed a significant correlation with 90-day functional outcome (r = −0.217, p = 0.002), with higher HRR values observed in patients with good outcome compared to those with poor outcome (median 1.063 vs 1.000, p = 0.008). Similarly, in intracerebral hemorrhage, HRR was significantly associated with 90-day functional outcome, and patients with good outcome had higher HRR values than those with poor outcome (median 1.092 vs 0.986, p = 0.04). Conclusions HRR is associated with long-term functional outcome in both ischemic and hemorrhagic stroke, suggesting its potential role as a simple, inexpensive, and widely available biomarker for early prognostication in acute stroke care. Conflict of interest