Abstract: Objective To explore the predictive value of red blood cell distribution width (RDW) for the outcome of
intravenous thrombolysis in patients with acute ischemic stroke (AIS). Methods A total of 122 patients with AIS admitted
to the Department of Neurology, the Second Hospital of Tianjin Medical University for the treatment of intravenous
thrombolysis between January 2017 and January 2019 were enrolled retrospectively. Three months after treatment, the
clinical outcome was assessed by the modified Rankin scale (mRS). The score of 0-2 was defined as good outcome, and>2
was defined as poor outcome. Clinical basic data, blood count and biochemical data were compared between the two groups.
Multivariate Logistic regression analysis was used to determine the independent risk factors for poor outcome. Receiver
operator characteristic (ROC) curve was used to analyze the predictive value of RDW for poor outcome after intravenous
thrombolysis in patients with AIS. Results In 122 patients, 69(56.6%) showed good outcome and 53(43.4%) showed poor
outcome. The proportions of hypertension, stroke, heart disease, atrial fibrillation and the values of age, baseline National
Institutes of Health Stroke Scale (NIHSS) score, fasting blood glucose (FBG), high sensitivity C-reactive protein (hs-CRP),
uric acid (UA) and RDW were significantly higher in poor outcome group than those in good outcome group (P＜0.05).
Multivariate Logistic regression analysis showed that high FBG level, high NIHSS score and elevated RDW were the
independent risk predictors of poor outcome after intravenous thrombolysis in patients with AIS. The cutoff RDW value for
predicting poor outcome after intravenous thrombolysis in patients with AIS was more than 13.15% with a sensitivity of
62.3% and a specificity of 84.1% (area under the curve, 0.754; 95% confidence interval 0.665-0.843). Conclusion The
elevated RDW is an independent risk factor for poor outcome after intravenous thrombolysis in patients with AIS. RDW has a certain predictive value for outcome after intravenous thrombolysis in patients with AIS.

Key words: stroke, brain ischemia, thrombolytic therapy, tissue plasminogen activator, treatment outcome, risk factors