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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">JCNR</journal-id><journal-title-group><journal-title>Journal of Clinical and Nursing Research</journal-title></journal-title-group><issn>2208-3685</issn><eissn>2208-3693</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/jcnr.v8i2.6031</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>The Prognostic Value of Red Cell Distribution  Width in Critically Ill Cerebral Infarction Patients: A Retrospective Cohort Study</title><url>https://artdesignp.com/journal/JCNR/8/2/10.26689/jcnr.v8i2.6031</url><author>ZhaoLingyan,WuLinna,LiGui-Ping</author><pub-date pub-type="publication-year"><year>2024</year></pub-date><volume>8</volume><issue>2</issue><history><date date-type="pub"><published-time>2024-02-26</published-time></date></history><abstract>Objective: Red blood cell distribution width (RDW) has been utilized as a prognostic indicator for mortality risk assessment in cardiovascular and cerebrovascular patients. Nevertheless, the prognostic significance of RDW in critically ill patients with cerebral infarction is yet to be investigated. The objective of this study is to examine the association between RDW and the risk of all-cause mortality in cerebral infarction patients admitted to the intensive care unit (ICU). Method: A retrospective cohort study was conducted using the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV) intensive care dataset for data analysis. The main results were the all-cause mortality rates at 3 and 12 months of follow-up. Cumulative curves were plotted using the Kaplan-Meier method, and Cox proportional hazards analysis was used to examine the relationship between RDW and mortality rates in critically ill cerebral infarction patients. Results: The findings indicate that RDW serves as a significant prognostic factor for mortality risk in critically ill stroke patients, specifically at the 3 and 12-month follow-up periods. The observed correlation between increasing RDW levels and higher mortality rates among cerebral infarction patients further supports the potential utility of RDW as a predictive indicator. Conclusion: RDW emerges as an independent predictor of mortality risk during the 3 and 12-month follow-up periods for critically ill patients with cerebral infarction.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Feigin VL, 2018, Global, Regional, and Country-Specific Lifetime Risks of Stroke. N Engl J Med, 379: 2429–2437.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>Mozaffarian D, Benjamin EJ, Go AS, et al:, 2016, Heart Disease and Stroke Statistics—2016 Update. Circulation, 133(4): e38–e360.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B3" content-type="article"><label>3</label><element-citation publication-type="journal"><p>Gorelick PB, 2019, The Global Burden of Stroke: Persistent and Disabling. The Lancet Neurology, 18(5): 417–418.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B4" content-type="article"><label>4</label><element-citation publication-type="journal"><p>Kernan WN, Ovbiagele B, Black HR, et al:, 2014, Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke, 45(7): 2160–2236.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B5" content-type="article"><label>5</label><element-citation publication-type="journal"><p>Langhorne P, Fearon P, Ronning OM, et al:, 2013, Stroke Unit Care Benefits Patients With Intracerebral Hemorrhage. Stroke, 44(11): 3044–3049.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B6" content-type="article"><label>6</label><element-citation publication-type="journal"><p>Salvagno GL, Sanchis-Gomar F, Picanza A, et al., 2014, Red Blood Cell Distribution Width: A Simple Parameter with Multiple Clinical Applications. Critical Reviews in Clinical Laboratory Sciences, 52(2): 86–105.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B7" content-type="article"><label>7</label><element-citation publication-type="journal"><p>Zhao Z, 2014, Elevated Red Cell Distribution Width Level is Associated with Oxidative Stress and Inflammation in a Canine Model of Rapid Atrial Pacing. Int J Cardiol, 174(1): 174–176.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B8" content-type="article"><label>8</label><element-citation publication-type="journal"><p>Ye?il A, ?enate? E, Bayo?lu ?V, et al., 2011, Red Cell Distribution Width: A Novel Marker of Activity in Infl ammatory Bowel Disease. Gut and Liver, 5(4): 460–467.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B9" content-type="article"><label>9</label><element-citation publication-type="journal"><p>Chee Y, Seneviratna A, Lim CJ, et al., 2019, Red Cell Distribution Width is Associated with Mortality and Cardiovascular Complications in Diabetes Mellitus in Singapore. European Journal of Preventive Cardiology, 27(2): 216–219.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B10" content-type="article"><label>10</label><element-citation publication-type="journal"><p>Geisen MAH, Ebm C, Hamilton MA, et al., 2013, Red Cell Distribution Width Predicts Cardiovascular Complications After High-Risk Surgery. Critical Care, 17: P232.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B11" content-type="article"><label>11</label><element-citation publication-type="journal"><p>Zhang X, Wang Y, Chen N, et al., 2022, Red Cell Distribution Width is Associated with Short?Term Mortality in Critically Ill Patients with Heart Failure. ESC Heart Failure, 9(5): 3210–3220.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B12" content-type="article"><label>12</label><element-citation publication-type="journal"><p>Adamsson Eryd S, Borné Y, Melander O, et al., 2013, Red Blood Cell Distribution Width is Associated with Incidence of Atrial Fibrillation. Journal of Internal Medicine, 275(1): 84–92.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B13" content-type="article"><label>13</label><element-citation publication-type="journal"><p>Tonelli M, Sacks F, Arnold M, et al., 2008, Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People with Coronary Disease. Circulation, 117(2): 163–168.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B14" content-type="article"><label>14</label><element-citation publication-type="journal"><p>Hansen J-B, Brækkan SK, Brox J, et al., 2017, Red Cell Distribution Width is Associated with Future Risk of Incident Stroke. Thrombosis and Haemostasis, 115(01): 126–134.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B15" content-type="article"><label>15</label><element-citation publication-type="journal"><p>Bovi P, Ricci G, Bovo C, et al., 2016, Red Blood Cell Distribution Width Is an Independent Predictor of Outcome in Patients Undergoing Thrombolysis for Ischemic Stroke. Seminars in Thrombosis and Hemostasis 43(01): 30–35.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B16" content-type="article"><label>16</label><element-citation publication-type="journal"><p>Otero TMN, Canales C, Yeh DD, et al., 2016, Elevated Red Cell Distribution Width at Initiation of Critical Care is Associated with Mortality in Surgical Intensive Care Unit Patients. Journal of Critical Care, 34: 7–11.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B17" content-type="article"><label>17</label><element-citation publication-type="journal"><p>Hunziker S, Celi LA, Lee J, et al., 2012, Red Cell Distribution Width Improves the Simplified Acute Physiology Score for Risk Prediction in Unselected Critically Ill Patients. Critical Care 16(3): R89.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B18" content-type="article"><label>18</label><element-citation publication-type="journal"><p>18. Daland GA, Heath CW, Minot GR, 1946, Differentiation of Pernicious Anemia and Certain Other Macrocytic Anemias by the Distribution of Red Blood Cell Diameters. Blood, 1: 67–75.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B19" content-type="article"><label>19</label><element-citation publication-type="journal"><p>Charles R, Kiefer LMS, 2000, Oxidation and Erythrocyte Senescence. Curr Opin Hematol, 17(5): 446–452.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B20" content-type="article"><label>20</label><element-citation publication-type="journal"><p>Osawa Y, Tanaka T, Semba RD, et al., 2022, Proteins in the Pathway from High Red Blood Cell Width Distribution to All-Cause Mortality. eBioMedicine, 76: 103816.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B21" content-type="article"><label>21</label><element-citation publication-type="journal"><p>Tozzi-Ciancarelli MG, Di Giulio A, Troiani-Sevi E, et al., 1989, Human Erythrocyte Damage at the Initial Stages of Oxidative Stress. Cell Biophys, 15(3): 225–234.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B22" content-type="article"><label>22</label><element-citation publication-type="journal"><p>Friedman JS, Lopez MF, Fleming MD, et al., 2004, SOD2-Deficiency Anemia: Protein Oxidation and Altered Protein Expression Reveal Targets of Damage, Stress Response, And Antioxidant Responsiveness. Blood 104(8): 2565–2573.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B23" content-type="article"><label>23</label><element-citation publication-type="journal"><p>Kahles T, Brandes RP, 2012, NADPH Oxidases as Therapeutic Targets in Ischemic Stroke. Cellular and Molecular Life Sciences 69(14): 2345–2363.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B24" content-type="article"><label>24</label><element-citation publication-type="journal"><p>Chen H, Yoshioka H, Kim GS, et al., 2011, Oxidative Stress in Ischemic Brain Damage: Mechanisms of Cell Death and Potential Molecular Targets for Neuroprotection. Antioxid Redox Signal, 14(8): 1505–1517.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B25" content-type="article"><label>25</label><element-citation publication-type="journal"><p>Kahles T, Luedike P, Endres M, et al., 2007, NADPH Oxidase Plays a Central Role in Blood-Brain Barrier Damage in Experimental Stroke. Stroke, 38(11): 3000–3006.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B26" content-type="article"><label>26</label><element-citation publication-type="journal"><p>Casas AI, Geuss E, Kleikers PWM, et al, 2017, NOX4-Dependent Neuronal Autotoxicity and BBB Breakdown Explain the Superior Sensitivity of The Brain to Ischemic Damage. Proceedings of the National Academy of Sciences, 114(46): 12315–12320.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B27" content-type="article"><label>27</label><element-citation publication-type="journal"><p>Canty Jr TG, Boyle Jr EM, Farr A, et al., 1999, Oxidative Stress Induces NF-kappaB Nuclear Translocation Without Degradation of IkappaBalpha. Circulation, 100: II361-4.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B28" content-type="article"><label>28</label><element-citation publication-type="journal"><p>McLeod M, Kleinschnitz C, Grund H, et al:, 2010, Post-Stroke Inhibition of Induced NADPH Oxidase Type 4 Prevents Oxidative Stress and Neurodegeneration. PLoS Biology 8(9): e1000479.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B29" content-type="article"><label>29</label><element-citation publication-type="journal"><p>Wu H, Liao B, Cao T, et al., 2022, Diagnostic Value of RDW for the Prediction of Mortality in Adult Sepsis Patients: A Systematic Review and Meta-Analysis. Frontiers in Immunology 13.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B30" content-type="article"><label>30</label><element-citation publication-type="journal"><p>Zhang L, Yu C, Guo K, et al., 2020, Prognostic Role of Red Blood Cell Distribution Width in Patients with Sepsis: A Systematic Review and Meta-Analysis. BMC Immunology, 21(1): 40.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B31" content-type="article"><label>31</label><element-citation publication-type="journal"><p>Yonemoto S, Hamano T, Fuji Naohiko, et al, 2018, Red Cell Distribution Width and Renal Outcome in Patients with Non-Dialysis-Dependent Chronic Kidney Disease. Plos One, 13(6): e0198825.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B32" content-type="article"><label>32</label><element-citation publication-type="journal"><p>Wei Z, Zhang F, Ma X, et al., 2022, Preoperative Red Blood Cell Distribution Width as an Independent Prognostic Factor in Metastatic Renal Cell Carcinoma. Translational Oncology, 23: 101486.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
