Risk Factors Of Post-stroke Depression And Red Blood Cell Distribution Width On Its Predictive Value

Objective Stroke can be seen as a clinical manifestation of insufficient blood supply to the brain.A stroke occurs when the arteries supplying blood to a certain part of the brain are ruptured or blocked,causing neurons in the affected area to lack the oxygen and nutrients normally provided by the blood.There are two basic types of stroke:ischemic and hemorrhagic.This classification has important practical significance for the treatment and prognosis of stroke.Among them,ischemic stroke is more common than hemorrhagic stroke.Stroke is currently the second leading cause of death in the world and a common and frequently-occurring disease in neurology.Data show that the incidence of stroke increased rapidly from 2002 to 2013,with about 2.4 million new stroke patients each year.With the improvement of the level of stroke treatment,the number of stroke survivors continues to increase.Unfortunately,although stroke patients have undergone full treatment,stroke is still the main cause of disability.More than half of stroke patients require long-term care and rehabilitation.Therefore,paying attention to the psychological problems that stroke patients may face is a very important part of the treatment of stroke patients.The red blood cell distribution width(RDW)is increased in various inflammatory-related diseases,but their clinical significance in post-stroke depression(PSD)has not been reported.This study aims to explore the clinical value of risk factors for post-stroke depression and the distribution of red blood cells in post-stroke depression.Methods A retrospective observational study carried out in 185 patients with first?ever acute ischemic stroke(AIS)in the Second Hospital of Anhui Medical University between February 2019 and February 2020.PSD patients was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders-IV criteria at 6 months after stroke.Clinical and laboratory data were obtained from all patients.Results At 6 months follow-up,46 patients were diagnosed with PSD.Compared with non-PSD patients,RDW-CV and RDW-SD were increased in PSD patients and positively correlated with serum IL-6 concentrations.Only RDW-SD demonstrated a consistent positive association with HAM-D scores at 6-month after admission in PSD patients.RDW-CV,RDW-SD and IL-6 were identified as independent predictors of PSD.The areas under the receiver operating characteristic(ROC)curves(AUC)of RDW-SD were 0.796(95%CI:0.731-0.852)for the prediction of PSD,which was superior to that of RDW-CV.When the RDW-SD was greater than 43.80 fl,the sensitivity for predicting PSD was 91.30% and the specificity was 60.43%.Conclusions RDW-SD was a simple,inexpensive,rapid and easily accessible parameter that can be used in the prediction of PSD in patients with stroke.