Red Cell Distribution Width Ratio Research Articles

The relationship between hemoglobin-to-red cell distribution width (RDW) ratio (HRR) and mortality in stroke patients.

In recent years, many studies have shown that hemoglobin to red cell distribution width ratio (HRR), which is the ratio of hemoglobin (Hb) to red cell distribution width (RDW), is associated with inflammation. Inflammation is linked to both the development of stroke and the severe effects that follow. Therefore, the relationship between the HRR and mortality in patients with stroke was investigated in our study. 127 stroke patients who visited the emergency department between March 1, 2023, and June 1, 2023, were retrospectively evaluated. The National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity. All stroke patients were divided into four groups: patients with atrial fibrillation (AF), those without AF, and those with low and high HRR. HRR levels were compared between patients with and without AF. The relationship between HRR and mortality was also analyzed. HRR levels were found to be significantly lower in patients with AF compared to those without AF (p<0.05 for all). NIHSS, requirement for mechanical ventilation, and mortality rate were significantly higher in the low HRR (HRR≤0.795) group compared to the high HRR group (HRR>0.795) (p<0.05 for all). HRR outperformed Hb and RDW alone in predicting mortality (AUC; 0.975, 0.952, 0.911, respectively). Additionally, a significant positive correlation was found between HRR levels and NIHSS (p<0.001). Low HRR measured on admission is a useful marker for predicting mortality and determining the severity of stroke.

Hemoglobin to red cell distribution width ratio as a prognostic marker for ischemic stroke after mechanical thrombectomy

Hemoglobin to red cell distribution width ratio as a prognostic marker for ischemic stroke after mechanical thrombectomy

Hemoglobin red cell distribution width ratio as a prognostic marker in patients with locally advanced lung adenocarcinoma

Aims: Hemoglobin/red cell distribution width ratio (HRR) has been defined as an effective prognostic factor in various malignancies. The aim of this study is to investigate the prognostic role of HRR in locally advanced lung adenocarcinoma.&#x0D; Methods: 626 patients diagnosed with locally advanced lung adenocarcinoma were screened. The best cut-off point of HRR for overall survival (OS) and progression free survival (PFS) was determined by ROC analysis. A HRR cut-off value was determined, patients were classified as having lower or higher HRR. Both groups’ clinical, demographic, laboratory values were compared. To identify independent predictors of prognosis, multivariate cox regression analysis was used.&#x0D; Results: A total of119 patients were included. The best cut-off point of HRR in determining OS was 0.963%.HRR below the cut-off value increased mortality by 2.2fold.The group with HRR

Prognostic significance of prognostic nutritional index and hemoglobin to red cell distribution width ratio in metastatic colorectal cancer patients

Aims: Malnutrition and systemic inflammation are poor prognostic factors in cancer. Prognostic nutritional index (PNI) and Hemoglobin to red blood cell distribution witdh (HRR) are considered indicators of malnutrition and systemic inflammation. We aimed to investigate the prognostic importance of PNI and HRR on metastatic colorectal cancer survival.&#x0D; Methods: We retrospectively reviewed all patients diagnosed with metastatic colorectal cancer treated at Kayseri City Training and Research Hospital and Erciyes University Medical School. PNI is calculated as (serum albumin (g/L) +5 x total lymphocyte count (10⁹/L)). And HRR was calculated as the ratio of hemoglobin (g/dl) and RDW (%). PNI was divided into two groups based on the cut off points 46.175 as PNI high and low. And we compared these two groups according to general characteristics and overall survival. We performed another comparision between HRR low and high groups based on the cut off points 0.8675 according to general characteristics and overall survival. Kaplan Meier method was used to analyse overall survival and compared survival rates with the log-rank test.&#x0D; Results: We reviewed 346 metastatic colorectal cancer patients and we included 145 of them who fit to inclusion criteria to the study. Univariate analysis revealed that presence of initially metastatic disease, right located tumor, low HRR, low PNI were independent prognostic markers of poor overall survival. In multivariate analysis, presence of initially metastatic disease and low PNI remain statistically significant independent prognostic markers of poor survival. The median overall survival was statistically longer in HRR and PNI low groups than high groups.&#x0D; Conclusion: Both PNI and HRR are associated with poor overall survival in metastatic colorectal cancer.

Hemoglobin to red cell distribution width ratio: A predictor of clinical outcome and diuretic response in patients with acute heart failure

BackgroundHemoglobin to Red Cell Distribution Width Ratio (HRR) is a novel inflammatory marker in the prognostic assessment of tumors. Nevertheless, its focus on the cardiovascular field is relatively limited, particularly regarding its correlation with diuretic responses and clinical outcomes. MethodsThis is a secondary analysis of the Renal Optimization Strategies Evaluation (ROSE AHF) clinical trial. The outcomes of interest included all-cause death, rehospitalization and diuretic responses. Multivariable Cox proportional hazard regression and linear regression models were performed, respectively. Prognostic outcomes and diuretic response were further evaluated in ejection fraction (EF) subgroups (preserved EF ≥ 50% and reduced EF<50%). ResultsA total of 351 patients were included in the present study and further categorized according to HRR median (0.7131) value at admission: low HRR group (n = 176) and high HRR group (n = 175). High HRR were found to be independently associated with decreased risk of all-cause death (HR = 0.51; 95% CI,0.30–0.87, P = 0.013), reduced risk of developing all-caused death or rehospitalization (HR = 0.62; 95% CI,0.39–0.98, P = 0.039). Furthermore, high HRR indicated lower cumulative urine output (OR: -992.33, P = 0.004) and less weight loss (OR: 3.08, P < 0.001) within 72 h after diuresis. Subgroup analysis revealed no significant interaction effect between EF and HRR in prognostic impact or diuretic responses, and HRR was negatively correlated with plasma volume. ConclusionHigh HRR demonstrated a lower risk of developing adverse clinical outcomes and a poorer diuretic response that might be due to less volume overload in AHF patients.

A new prognostic marker in small cell lung cancer: red cell distribution width ratio of hemoglobin

Aim: The ratio of hemoglobin (Hb) to red cell distribution width (RDW) (HRR) has been defined as an effective prognostic factor in various cancer types. The aim of this study is to investigate the prognostic role of HRR value in small cell lung cancer (SCLC). Material and Method: A total of 1039 patients diagnosed with SCLC between 2010-2021 were included in the study. After exclusion of 199 patients without positron emission tomography-computerized tomography (PET-CT), age, gender, additional disease histories, smoking history, pathological stages, survival status, disease progression times, treatments applied, first hemoglobin obtained after diagnosis, red cell distribution width and ratios, and other laboratory parameters of 840 patients were recorded. The log-rank test and the Cox proportional hazards model were used to identify predictors of mortality. Results: A total of 840 patients were included in the study. The median overall survival (OS) and the progression-free survival (PS) times of the patients were 9 months, and 7 months, respectively. The cut-off value for HRR was determined 0.580 (sensitivity 78.73%, specificity 37.88%). In this study, each one-unit increase in HRR reduces death and survival by 1.6 times detected, and it was revealed that HRR had a statistically significant effect on OS and PS. When the patients were divided into two as limited and extensive disease, there was a statistically significant difference between the groups in terms of OS (12-6 months) and PS (10-6 months), but no significant difference was found in terms of HRR between these two groups. Conclusion: HRR is an easily accessible, inexpensive parameter that can be used as a prognostic marker in patients with SCLC.

A Novel Prognostic Score Including the CD4/CD8 for AIDS-Related Lymphoma.

BackgroundA simple and clinically applicable prognostic scoring system for AIDS-related lymphoma (ARL) in the era of combination antiretroviral therapy (cART) is needed to better stratify patients’ risks and to assist in the decision-making of therapeutic strategies.MethodsWe conducted a retrospective multicenter cohort study in 138 primary ARL patients over an 8-year period from 2013 to 2020. Survival curves were estimated using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazard models were performed to identify the association between patient-, lymphoma-, and HIV-specific variables with progression-free survival (PFS) and overall survival (OS). The incremental prognostic value of novel inflammatory biomarkers in the International Prognostic Index (IPI) was evaluated by comparing the receiver operating characteristic (ROC) curves, the concordance index (C-index), and the integrated Brier score (IBS).ResultsThe median age was 49.14 ± 14.20 (range 18–79) years, 81.9% were men, and the median follow-up was 44.94 (95% CI = 37.05–52.84) months. The 3-year OS and PFS were 39.4% (95% CI = 16.3–21.2) and 38.7% (95% CI = 14.5–19.7), respectively. We found that age, extranodal sites, bulky mass, CD4 T-cell counts, CD4/CD8 ratio, and hypoalbuminemia were associated with OS (all P < 0.05) at both univariate and multivariate analyses. Of the new inflammatory markers, only the CD4/CD8 ratio was an independent prognostic parameter of OS and PFS. A lower CD4/CD8 ratio was strongly associated with adverse clinical factors, including older age, advanced Ann Arbor stage, more extranodal sites, elevated erythrocyte sedimentation rate, prior history of HIV, higher red cell distribution width ratio, hypoproteinemia, and emaciation. When the CD4/CD8 ratio was added to the IPI, the composite HIV-IPI score showed significantly better discrimination than IPI alone [AUC (95% CI): HIV-IPI, 0.83 (0.77–0.89) vs. IPI, 0.72 (0.70–0.85)]. The HIV-IPI model provided good predictive performance [C-index (95% CI): HIV-IPI, 0.82 (0.81–0.83) vs. IPI, 0.75 (0.73–0.77), P < 0.001] and a satisfactory calibration function.ConclusionsThe CD4/CD8 ratio, an inexpensive and readily available marker, is a powerful independent prognostic parameter in patients with ARL. Furthermore, when the CD4/CD8 ratio is used in combination with IPI, it increases prognostic ability. The useful prediction of expected outcomes in ARL can inform treatment decisions.

Platelet to red cell distribution width ratio for predicting clopidogrel efficacy in patients undergoing percutaneous coronary interventions: insights from the ONSIDE-TEST study.

INTRODUCTION Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel remains a cornerstone of pharmacotherapy after percutaneous coronary intervention (PCI). It has been demonstrated that even up to 30% of patients receiving DAPT have inadequate response to clopidogrel, namely, high on‑treatment platelet reactivity (HPR). The platelet to red cell distribution width (P‑RDW) ratio represents an indicator of cardiovascular risk and may be related to HPR. OBJECTIVES The aim of the present study was to establish whether the P‑RDW ratio predicts HPR in clopidogrel‑treated patients undergoing elective PCI. PATIENTS AND METHODS This was a subanalysis of the prospective randomized‑controlled ONSIDE TEST study. A total of 70 patients were included in the analysis, of whom 12 were identified with HPR. The HPR was defined as the values above the threshold of 208 platelet reactivity units (PRU >208) by the VerifyNowP2Y12 assay. RESULTS The P‑RDW ratio was lower in patients with HPR than in those without HPR (mean [SD], 14.37 [4.13] vs 17.734 [4.96]; P = 0.03). A logistic regression analysis showed that the P‑RDW ratio was associated with HPR (P = 0.03). Using a cut‑off level of 15.23, the P‑RDW ratio predicted HPR with a sensitivity of 69% and specificity of 75% (odds ratio, 6.67; 95% CI, 0.561-0.890; P = 0.02; are under the receiver operating characteristic curve, 0.723). CONCLUSIONS The P‑RDW ratio may serve as a supplementary tool for identification of patients at risk of HPR. Further studies are warranted to assess its role in planning DAPT among patients undergoing PCI.

TCT-646 Platelet to red cell distribution width ratio predicts high on-clopidogrel platelet reactivity in patients with percutaneous coronary intervention

Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel remains a cornerstone of pharmacotherapy after percutaneous coronary intervention(PCI). It has been demonstrated that even up to 30% of patients receiving DAPT is characterized by inadequate response to clopidogrel, namely high on-

Preoperative blood-routine markers and prognosis of esophageal squamous cell carcinoma: The Fujian prospective investigation of cancer (FIESTA) study.

This prospective study was designed to investigate the prognosis of preoperative blood-routine markers for esophageal cancer mortality by using data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. Patients who received three-field lymphadenectomy for esophageal cancer between 2000 and 2010 were enrolled. Of 2535 patients with complete survival data, esophageal squamous cell carcinoma (ESCC) accounted for 94.5% (n = 2396). Here, only ESCC patients were analyzed, with the median follow-up time of 38.2 months (range: 0.5 to 180 months). Of 10 blood-routine markers evaluated, platelet count and red cell distribution width (RDW) were two significant predictors for ESCC mortality in men (adjusted hazard ratio or HR = 1.25 and 0.84, 95% confidence interval or CI: 1.08-1.22 and 0.75-0.93, P < 0.001 and P = 0.001, respectively), while in women only lymphocyte showed marginal significance. Based on individual results, a new derivate calculated as platelet count to RDW ratio (PRR) was created, and it was superior over other widely-evaluated derivates in men after adjustment (HR = 1.21, 95% CI: 1.13-1.30, P < 0.001), while there was no observable significance in women. In further stratified analyses, the prognosis of PRR for ESCC mortality was reinforced in men with tumor-node-metastasis stage III (HR, 95% CI, P: 1.18, 1.09-1.28, 0.001), invasion depth T3-T4 (1.17, 1.08-1.26, <0.001) or positive lymph node metastasis (1.37, 1.18-1.59, <0.001). Taken together, we created a new derivate PRR that was proven to be superior over other blood-routine markers and exhibited strong prognostic capability for ESCC mortality in Chinese men.

Red Cell Distribution Width Identifies Cerebral Venous Sinus Thrombosis in Patients With Headache

Diagnosing cerebral venous sinus thrombosis (CVST) in patients referring to emergency service or neurology outpatient unit with complaints of headache is a challenging task. Magnetic resonance (MR) venography is the gold standard, but there are limitations regarding its use. To evaluate the validity of red cell distribution width (RDW) in CVST diagnosis in patients presenting with headache. A total of 138 patients comprising 37 patients with CVST and 101 control primer headache cases were included in this retrospective cross-sectional study. Control group consists of hospitalized patients with primary headache. Venous blood hemoglobin (Hb), platelet, mean corpuscular volume (MCV), RDW, fibrinogen, and vitamin B12 levels of the patients were recorded at the first referral. Diagnosis of CVST was established by MR venography. The RDW ratio of patients with a diagnosis of CVST was significantly higher than that in patients with primary headache (15.3 ± 1.4 vs 13.3 ± 0.5; P <.0001). Fibrinogen and vitamin B12 levels were not significantly different between the 2 groups. In a total of 11 patients, there was more than 1 thrombosis. In 21 of the patients with CVST, gene mutation was detected. There was no significant difference between the patients with and without mutations regarding RDW values. Diagnostic validity of RDW was found to be excellent in differentiating patients with CVST and primary headache (area under the curve = 0.996; 95% CI: 0.990-1.000). Optimum RDW cutoff value was determined as 14.1% (sensitivity: 91.9%, specificity: 99%, positive predictive value: 92.8, negative predictive value: 0.082). We suppose that among patients presenting with the complaint of headache, RDW value may lead to diagnose CVST.