Türk Beyin Damar Hast Derg. 2022; 28(1): 31-37 | DOI: 10.5505/tbdhd.2022.04880

Serebral venöz trombozlarda, eritrosit daðýlým geniþliðinin (RDW) tanýsal ve prognostik deðeri

Hale Zeynep Batur Caglayan¹, Aslý Akyol Gürses¹, Havva Meltem Mutlucan², Ýlker Arslan¹, Zuhre Kaya³, Murat Uçar⁴, Bijen Nazliel^1
1Gazi Üniversitesi Týp Fakültesi, Nöroloji Anabilim Dalý, Ankara
²Batman Eðitim ve Araþtýrma Hastanesi, Algoloji Bilim Dalý, Batman
³Gazi Üniversitesi Týp Fakültesi, Pediatrik Hematoloji Bilim Dalý, Ankara
⁴Gazi Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Ankara

GÝRÝÞ ve AMAÇ: Bu çalýþmada, üçüncü basamak bir merkezde serebral venöz tromboz (SVT) olan hastalarda tam kan sayýmýndan elde edilen kolay eriþilebilir bir parametre olan eritrosit daðýlým geniþliðinin (RDW) tanýsal ve prognostik deðerinin deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Kliniðimizde takip edilen serebral ven trombozu olan 69 hastanýn týbbi kayýtlarý incelendi. Demografik özellikler, biyokimyasal parametreler, hemogram parametreleri, etkilenen venöz yapýlarýn lokalizasyonu, baþvuru NIHSS skorlarý ve taburculuk mRS skorlarý kaydedildi. Ayrýca 60 yaþ-cinsiyet uyumlu saðlýklý yetiþkinin demografik özellikleri ve hemogram deðerleri kaydedildi.
BULGULAR: RDW'nin hasta grubunda(14,58±2,33) kontrollere (12,99±0,76) göre anlamlý derecede yüksek olduðu gösterildi (p<0,001*). Ayrýca hastalarýn ortalama hemoglobin ve hematokrit deðerleri kontrollere göre daha düþük bulundu (p<0.05). ROC eðrisi analizinde, >%13,11'lik bir RDW deðerinin, SVT tanýsý için %73.9 duyarlýlýk ve %61.7 özgüllüðe sahip olduðu bulundu (AUC: 0.746 %95 CI: 0.662-0.829, p<0.001). RDW, mRS puanlarý ile anlamlý bir pozitif korelasyon gösterirken, NIHSS puanlarý ile ilgili herhangi bir korelasyon tespit edilmedi.
TARTIÞMA ve SONUÇ: Bu çalýþma, RDW ile SVT varlýðý arasýnda baðýmsýz bir iliþki olduðunu göstermektedir. RDW, rutin hemogram incelemelerinden elde edilen basit ve kolay eriþilebilir bir belirteçtir ve sonuçlarýmýz, SVT hastalarýnda tanýsal ve prognostik amaçlar için kullanýmýný desteklemektedir.

Anahtar Kelimeler: Kraniyal venöz sinus trombozu, eritrosit indeksleri, eritrosit daðýlým superior sagittal sinus, transvers sinüs trombozu, venöz enfarktüs.

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The diagnostic and prognostic value of red cell distribution width (RDW) in cerebral venous thrombosis

Hale Zeynep Batur Caglayan¹, Aslý Akyol Gürses¹, Havva Meltem Mutlucan², Ýlker Arslan¹, Zuhre Kaya³, Murat Uçar⁴, Bijen Nazliel^1
1Gazi University Faculty of Medicine, Department of Neurology, Ankara, Turkey
²Batman Rraining and Research Hospital, Department of Algology, Batman, Turkey
³Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
⁴Gazi University Faculty of Medicine, Department of Radiology, Ankara, Turkey

INTRODUCTION: This study aimed to assess the diagnostic and prognostic value of red cell distribution width (RDW)which is an easily accesible parameter obtained from complete blood count in patients with cerebral venous thrombosis (CVT) in a single tertiary center.
METHODS: Medical records of 69 patients with cerebral venous thrombosis who were followed in our clinic were reviewed. Demographic characteristics, biochemical parameters, hemogram parameters, localization of the affected venous structures, admission NIHSS scores and mRS scores at discharge were recorded. Demographic characteristics and hemogram values of 60 age-sex matched healthy adults were also recorded.
RESULTS: RDW was demonstrated to be significantly higher in patient group(14.58± 2.33) when compared to controls(12.99± 0.76) (p<0.001*). Besides, mean hemoglobin and hematocrit values of patients were found to be lower than controls (p<0.05). In ROC curve analysis, an RDW value of >13.11% was found to have a sensitivity of 73.9% and specificity of 61.7% for diagnosis of CVT (AUC: 0.746 95% CI: 0.662-0.829, p<0.001). RDW demonstrated a significant positive correlation with mRS scores whilst no correlation was detected regarding NIHSS scores.
DISCUSSION AND CONCLUSION: This study demonstrates an independent association between RDW and presence of CVT. RDW is a simple and easily accessible marker obtained from routine hemogram examinations and our results support its use for diagnostic, as well as prognostic purposes in CVT patients.

Keywords: Cranial cerebral venous sinus thrombosis, erythrocyte indices, Red Cell Distribution Width, sinus sagittalis superior, transverse sinus thrombosis, venous infarct.

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ATIF KOPYALA