红细胞分布宽度（RDW）已被认为是一种潜在的炎症生物标志物，其水平升高与各种疾病的不良后果相关。然而，其在预测脑肿瘤开颅手术后结果中的作用仍不清楚。我们的目的是评估术前 RDW 是否影响脑肿瘤开颅手术患者的死亡率和术后并发症。这项回顾性队列研究分析了华西医院接受脑肿瘤开颅手术患者的血清 RDW 水平。 RDW 以两种形式进行评估：RDW-CV 和 RDW-SD，并通过逻辑回归和多变量分析将其分为四个四分位数进行分析，以调整混杂因素。该研究涵盖了 10,978 名接受脑肿瘤开颅手术的患者。我们的分析显示，不同 RDW-CV 水平的 30 天死亡率没有显着差异。然而，我们在评估长期死亡风险时观察到术前 RDW-CV 水平的剂量反应关系。具体而言，RDW-CV 水平为 12.6-13.2%（HR 1.04，95% CI 1.01-1.18）、13.2-13.9%（HR 1.12，95% CI 1.04-1.26）和 > 13.9%（HR 1.34，95）的患者与 RDW-CV < 12.6% 的患者相比，% CI 1.18-1.51）表现出明显更高的长期死亡风险。当术前 RDW-CV 作为连续变量进行分析时，RDW-CV 每增加 10%，长期死亡率的调整 OR 为 1.09（95% CI 1.05-1.13）。我们还观察到术前较高的 RDW-CV 水平与某些术后并发症之间存在显着相关性，包括急性肾损伤（OR 1.46，95% CI：1.10-1.94）、肺炎感染（OR 1.19 95% CI：1.05-1.36）、心肌梗死（ OR 1.32，95% CI：1.05-1.66）、再入院（OR 1.15，95% CI：1.01-1.30）和住院时间延长（OR 1.11，95% CI：1.02-1.21）。对于RDW-SD水平，与短期死亡率、长期死亡率和术后并发症没有显着相关性。我们的研究表明，术前RDW-CV升高与长期死亡率和多种术后并发症的增加显着相关，但没有发现在 RDW-SD 中观察到了这种关联。这些发现显示了 RDW-CV 的预后重要性，增强了其作为脑肿瘤开颅手术患者术前评估中风险分层的宝贵工具的潜力。© 2024。作者获得 Springer-Verlag GmbH 德国的独家许可，施普林格自然的一部分。

Red cell distribution width (RDW) has been recognized as a potential inflammatory biomarker, with elevated levels associated with adverse outcomes in various diseases. However, its role in predicting outcomes after brain tumor craniotomy remains unclear. We aimed to assess whether preoperative RDW influences mortality and postoperative complications in patients undergoing brain tumor craniotomy.This retrospective cohort study analyzed serum RDW levels in patients undergoing brain tumor craniotomy at West China Hospital. RDW was evaluated in two forms: RDW-CV and RDW-SD, and was categorized into four quartiles for analysis by using logistic regression and multivariate analysis to adjust for confounding.The study encompassed 10,978 patients undergoing brain tumor craniotomy. our analysis revealed no significant difference in 30-day mortality across various RDW-CV levels. However, we observed a dose-response relationship with preoperative RDW-CV levels in assessing long-term mortality risks. Specifically, patients with RDW-CV levels of 12.6-13.2% (HR 1.04, 95% CI 1.01-1.18), 13.2-13.9% (HR 1.12, 95% CI 1.04-1.26), and > 13.9% (HR 1.34, 95% CI 1.18-1.51) exhibited a significantly higher hazard of long-term mortality compared to those with RDW-CV < 12.6%. When preoperative RDW-CV was analyzed as a continuous variable, for each 10% increase in RDW-CV, the adjusted OR of long-term mortality was 1.09 (95% CI 1.05-1.13). we also observed significant associations between preoperative higher RDW-CV levels and certain postoperative complications including acute kidney injury (OR 1.46, 95% CI: 1.10-1.94), pneumonia infection (OR 1.19 95% CI: 1.05-1.36), myocardial infarction (OR 1.32, 95% CI: 1.05-1.66), readmission (OR 1.15, 95% CI: 1.01-1.30), and a prolonged length of hospital stay (OR 1.11, 95% CI: 1.02-1.21). For RDW-SD levels, there was no significant correlation for short-term mortality, long-term mortality, and postoperative complications.Our study showed elevated preoperative RDW-CV is significantly associated with increased long-term mortality and multiple postoperative complications, but no such association is observed with RDW-SD. These findings show the prognostic importance of RDW-CV, reinforcing its potential as a valuable tool for risk stratification in the preoperative evaluation of brain tumor craniotomy patients.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.