Abstract
Purpose Red blood cell distribution width (RDW) is increased in a variety of inflammatory-related diseases. However, there is no report of its clinical significance in poststroke depression (PSD). This study explores the clinical significance of RDW in PSD patients. Methods A total of 185 patients with first-ever acute ischaemic stroke (AIS) in the Second Hospital of Anhui Medical University were chosen as subjects. A retrospective observational study was conducted from February 2019 to February 2020. PSD patients were diagnosed at 6 months after stroke based on the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Clinical and laboratory data were obtained from all patients. Coefficient of Variation (RDW-CV) and standard deviation (RDW-SD) were used to statistically report the performance of red blood cell distribution width. Results At the 6-month follow-up, 46 patients were diagnosed with PSD. Compared with non-PSD patients, PSD patients exhibited an increase in RDW-CV and RDW-SD, which positively correlated with serum interleukin 6 (IL-6) concentrations. In PSD patients, only RDW-SD demonstrated a consistent positive association with the Hamilton Rating Scale for Depression (HAM-D) scores at 6 months after admission. RDW-CV, RDW-SD, and IL-6 were recognized as independent predictors of PSD. The area under the receiver operating characteristic (ROC) curve (AUC) of RDW-SD was 0.796 (95% CI: 0.731-0.852) for the prediction of PSD, which was superior to that of RDW-CV. The specificity for predicting PSD was 60.43%, and the sensitivity was 91.30% if RDW-SD was higher than 43.80 fL. Conclusions RDW-SD is a simple, inexpensive, rapid, and easily accessible parameter that can be used to predict PSD in patients with stroke.
Highlights
Stroke, a major health problem in both globally developed and developing countries, took 6.24 million lives worldwide in 2005 [1]
The main aim of our study is to examine how Red blood cell distribution width (RDW) and Poststroke depression (PSD) are associated at 6 months and further determine RDW’s predictive value for PSD patients
Recent reports have shown that middle-aged PSD patients and stroke survivors without depression have different urine metabolism characteristics [14]
Summary
A major health problem in both globally developed and developing countries, took 6.24 million lives worldwide in 2005 [1]. The occurrence of PSD is related to unfavourable outcomes in terms of delayed neurological recovery and a decline in daily living abilities [3]. PSD has high mortality and disability rates, creating a heavy burden on society [4]. The importance of PSD has been recognized for decades and there are several screening tools for PSD [5], many PSD patients are often neglected because no effective biomarker has been established for PSD. The identification of potentially effective biomarkers for PSD through simple blood tests is the most attractive strategy due to its ability to reduce the time to diagnosis because of high patient acceptability
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