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

OBJECTIVE: 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. PATIENTS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: Low HRR measured on admission is a useful marker for predicting mortality and determining the severity of stroke.