术前红细胞分布宽度（RDW）升高与多种疾病的不良预后结果相关。然而，RDW (ΔRDW) 的变化与脑肿瘤开颅手术后的预后之间的相关性仍不清楚。因此，本研究旨在探讨脑肿瘤开颅手术患者围手术期RDW变化的预后意义。这项回顾性队列研究纳入了2011年1月至2021年3月在四川大学华西医院接受脑肿瘤开颅手术的患者。我们定义围手术期 RDW 变化：A 组（RDW 无显着变化，ΔRDW ≤0.4%），B 组（RDW 下降，ΔRDW < -0.4%），C 组（RDW 上升，ΔRDW >0.4%）。根据围手术期 ΔRDW（术后 1 周 RDW - 入院时 RDW）对患者进行分类，分析 RDW 变化与全因死亡率之间的关系。本研究共纳入 9589 例接受开颅手术治疗的患者。脑肿瘤。 RDW 的增加与死亡率增加显着相关，与 30 天死亡率相比，调整后的 OR 为 3.56 (95% CI: 2.56-4.95)，一年死亡率为 1.57 (95% CI: 1.33-1.85)。 RDW 变化不显着 (ΔRDW ≤0.4%)。相反，RDW 的降低与 30 天死亡率（调整后 OR：1.04，95% CI：0.53-2.04）和一年死亡率（调整后 OR：1.18，95% CI：0.92-1.53​​）没有显着相关性。这些发现也得到了限制三次样条的支持，该样条表明，与随访期间稳定的 RDW 水平相比，RDW 的增加与较低的生存率显着相关。在因脑肿瘤接受开颅手术的患者中，RDW 的增加与生存率降低显着相关。即使患者入院时的 RDW 值在正常范围内，也具有 30 天死亡率和较高的长期死亡风险。值得注意的是，在此期间保持稳定的 RDW 水平与更好的生存相关。版权所有 © 2024 Elsevier Inc. 保留所有权利。

An elevated preoperative red cell distribution width (RDW) is associated with adverse prognostic outcomes in various diseases. However, the correlation between changes in RDW (ΔRDW) and the prognosis following brain tumor craniotomy remains unclear. Accordingly, this study aimed to investigate the prognostic significance of perioperative changes in RDW in patients undergoing brain tumor craniotomy.This retrospective cohort study included patients undergoing craniotomy for brain tumors at West China Hospital, Sichuan University, from January 2011 to March 2021. We defined perioperative changes in RDW: group A (non-significant RDW changes, ΔRDW ≤0.4%), group B (drop in RDW, ΔRDW < -0.4%), and group C (rise in RDW, ΔRDW >0.4%). The relationship between the changes in RDW and all-cause mortality was analyzed by categorizing the patients according to perioperative ΔRDW (RDW at postoperative one week - RDW at admission).The present study included a total of 9589 patients who underwent craniotomy for the treatment of brain tumors. A rise in RDW was significantly associated with increased mortality, with an adjusted OR of 3.56 (95% CI: 2.56-4.95) for 30-day mortality and 1.57 (95% CI: 1.33-1.85) for one-year mortality compared to those with non-significant RDW changes (ΔRDW ≤0.4%). Conversely, a decrease in RDW showed no significant association with 30-day mortality (adjusted OR: 1.04, 95% CI: 0.53-2.04) and one-year mortality (adjusted OR: 1.18, 95% CI: 0.92-1.53). These findings were also supported by restricted cubic spline, which shows that increases in RDW were significantly associated with lower survival rates compared to stable RDW levels during the follow-up period.Among patients undergoing craniotomy for a brain tumor, a rise in RDW was associated with 30-day mortality and higher long-term mortality risks, even if patients' admissions for RDW values were within the normal range. It was worth noting that maintaining stable RDW levels during this period was associated with better survival.Copyright © 2024 Elsevier Inc. All rights reserved.