Correlation of red-blood-cell distribution width with National Institutes of Health Stroke Scale scores in acute ischemic stroke patients

BACKGROUND: Stroke is the second leading cause of death in the world and the most common cause of severe disability. In 2020, the global prevalence of all stroke subtypes was 89.13 million cases, and the prevalence of acute ischemic stroke was 68.16 million cases. Red distribution width (RDW) is a measurement of red blood cell volume variation used as a biomarker to assess severity and prognosis in stroke patients. Elevated levels are associated with a higher risk of death from acute ischemic stroke. The National Institutes of Health Stroke Scale (NIHSS) Score can be used to assess the severity of acute ischemic stroke. The aim of this study was to determine the relationship of RDW to the NIHSS Score of acute ischemic stroke at Marina Permata Hospital, South Kalimantan.METHODS: The study used a cross-sectional design. Data were taken from medical records of acute ischemic stroke patients hospitalized at Marina Permata Hospital from July to December 2023. Inclusion criteria were acute ischemic stroke patients determined based on the results of history taking, physical examination, and head CT scan. Exclusion criteria were microcytic and macrocytic anemia, history of blood disorders, and pregnancy. RDW and NIHSS scores were taken on the day of hospital admission and tested for correlation with the Spearman Test.RESULTS: Fifty-four subjects met the study criteria; the average age of men was 58.19 years and women 58.15 years. The most common risk factor was hypertension at 92.6%. In this study there was a weak significant correlation between RDW and NIHSS scores for acute ischemic stroke (r=0.293 and P=0.031). High RDW levels indicate high NIHSS scores, which means high severity of stroke patients. Inflammatory processes and oxidative stress have an important role in this occurrence. So that RDW can be a biomarker in assessing the severity and prognosis of acute ischemic stroke patients.CONCLUSIONS: There is a relationship between RDW levels and NIHSS scores of acute ischemic stroke patients. The higher the RDW level, the higher the NIHSS Score is.