Red blood cell distribution width is an independent predictor of mortality in patients with aneurysmal subarachnoid hemorrhage

Abstract

ObjectivesThis study was performed to evaluate the association between red blood cell distribution width (RDW) and 3-month mortality in patients with aneurysmal subarachnoid hemorrhage. Patients and methodsThis observational study was performed from March 2007 to May 2017 in an emergency department. The baseline characteristics and clinical and laboratory data were collected prospectively and analyzed. Clinical outcomes included 3-month mortality and poor functional outcome referred to as modified Rankin scale 3–6. ResultsA total 364 patients were included, and the overall 3-month mortality was 8.5%. The median RDW increased with disease severity classified according to the Hunt and Hess scale. RDW was significantly higher in patients with poor functional outcome than in patients with good functional outcome. The optimal RDW cutoff for predicting 3-month mortality was 13.9%.Cox regression analysis showed that higher RDW was independently associated with 3-month mortality (hazard ration 17.187, 95% CI 4.474–66.022). The area under the receiver-operating curve for RDW was 0.917 (95% CI 0.883–0.943). ConclusionAn elevated RDW is associated with poor functional outcome and 3-month mortality in patients with aneurysmal subarachnoid hemorrhage.