title: Red cell distribution width and neurological scoring systems in acute stroke patients.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the association between the red blood cell distribution width (RDW) and the Glasgow Coma Scale (GCS), Canadian Neurological Scale (CNS), and National Institutes of Health Stroke Scale (NIHSS) scores in patients who had acute ischemic stroke.
  
  
  METHODS
  This prospective observational cohort study included 88 patients who have had acute ischemic stroke and a control group of 40 patients who were evaluated in the Emergency Department for disorders other than acute ischemic stroke. All subjects had RDW determined, and stroke patients had scoring with the GCS, CNS, and NIHSS scores. The GCS, CNS, and NIHSS scores of the patients were rated as mild, moderate, or severe and compared with RDW.
  
  
  RESULTS
  Stroke patients had significantly higher median RDW than control subjects. The median RDW values were significantly elevated in patients who had more severe rather than milder strokes rated with all three scoring systems (GCS, CNS, and NIHSS). The median RDW values were significantly elevated for patients who had moderate rather than mild strokes rated by GCS and CNS and for patients who had severe rather than mild strokes rated by NIHSS. The area under the receiver operating characteristic curve was 0.760 (95% confidence interval, 0.676-0.844). Separation of stroke patients and control groups was optimal with RDW 14% (sensitivity, 71.6%; specificity, 67.5%; accuracy, 70.3%).
  
  
  CONCLUSIONS
  In stroke patients who have symptoms <24 hours, the RDW may be useful in predicting the severity and functional outcomes of the stroke.
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kara
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Degirmenci
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Bayir
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ak
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akinci
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Dogru
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Fikret
authors.initials: F
authors.lastname: Akyurek
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
authors.forename: Seyit Ali
authors.initials: SA
authors.lastname: Kayis
keywords: cerebrovascular accident; hematology; prognosis; severity
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