■红细胞分布宽度(RDW)与多种疾病的预后密切相关。然而,目前尚不清楚RDW与卒中患者消化道出血(GIB)之间的联系.本研究旨在阐明这种关联。
■这项回顾性研究涉及美国208家医院的11,107名住院患者,2014年1月1日至2015年12月31日期间入院。我们检查了重症监护病房(ICU)的7,512例中风患者的临床数据。多因素logistic回归分析了脑卒中患者RDW与院内GIB之间的联系。利用广义加性模型(GAM)和平滑曲线拟合(惩罚样条法)探讨脑卒中患者RDW与GIB的非线性关系。拐点是使用递归算法计算的,通过亚组分析评估不同变量之间的相互作用.
■在11,107名接受筛查的中风患者中,主要分析中包括7,512,190人被确定为患有GIB。参与者的平均年龄为(61.67±12.42)岁,RDW中位数为13.9%。多因素logistic分析显示RDW是脑卒中患者院内GIB的危险因素(OR=1.28,95%CI1.21,1.36,p<0.05)。发现脑卒中患者RDW与院内GIB之间的关系是非线性的。此外,RDW的拐点为14.0%。当RDW≥14.0%时,与GIB风险呈正相关(OR:1.24,95%CI:1.16,1.33,p<0.0001)。相反,当RDW<14.0%时,这种关联并不显著(OR:1.02,95%CI:0.97-1.07,p=0.4040).
■这项研究表明,卒中患者RDW与GIB风险之间存在实质性的非线性联系。维持患者的RDW值低于14.0%可降低院内GIB的风险。
UNASSIGNED: The red blood cell distribution width (RDW) is closely linked to the prognosis of multiple diseases. However, the connection between RDW and gastrointestinal bleeding (GIB) in stroke patients is not well understood. This study aimed to clarify this association.
UNASSIGNED: This retrospective study involved 11,107 hospitalized patients from 208 hospitals in the United States, admitted between January 1, 2014, and December 31, 2015. We examined clinical data from 7,512 stroke patients in the intensive care unit (ICU). Multivariate logistic regression assessed the link between RDW and in-hospital GIB in stroke patients. Generalized additive model (GAM) and smooth curve fitting (penalty spline method) were utilized to explore the non-linear relationship between RDW and GIB in stroke patients. The inflection point was calculated using a recursive algorithm, and interactions between different variables were assessed through subgroup analyses.
UNASSIGNED: Among the 11,107 screened stroke patients, 7,512 were included in the primary analysis, with 190 identified as having GIB. The participants had a mean age of (61.67 ± 12.42) years, and a median RDW of 13.9%. Multiple logistic analysis revealed RDW as a risk factor for in-hospital GIB in stroke patients (OR = 1.28, 95% CI 1.21, 1.36, p < 0.05). The relationship between RDW and in-hospital GIB in stroke patients was found to be non-linear. Additionally, the inflection point of RDW was 14.0%. When RDW was ≥14.0%, there was a positive association with the risk of GIB (OR: 1.24, 95% CI: 1.16, 1.33, p < 0.0001). Conversely, when RDW was <14.0%, this association was not significant (OR: 1.02, 95% CI: 0.97-1.07, p = 0.4040).
UNASSIGNED: This study showed a substantial non-linear link between RDW and the risk of GIB in stroke patients. Maintaining the patient\'s RDW value below 14.0% could lower the risk of in-hospital GIB.