Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients

Published on 2019-11-14T13:06:13Z (GMT) by
<div>Introduction<p>Alterations in haemoglobin levels are frequent in stroke patients. The prognostic meaning of anaemia and polyglobulia on outcomes in patients treated with intravenous thrombolysis is ambiguous.</p>Patients and methods<p>In this prospective multicentre, intravenous thrombolysis register-based study, we compared haemoglobin levels on hospital admission with three-month poor outcome (modified Rankin Scale 3–6), mortality and symptomatic intracranial haemorrhage (European Cooperative Acute Stroke Study II-criteria (ECASS-II-criteria)). Haemoglobin level was used as continuous and categorical variable distinguishing anaemia (female: <12 g/dl; male: <13 g/dl) and polyglobulia (female: >15.5 g/dl; male: >17 g/dl). Anaemia was subdivided into mild and moderate/severe (female/male: <11 g/dl). Normal haemoglobin level (female: 12.0–15.5 g/dl, male: 13.0–17.0 g/dl) served as reference group. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated with logistic regression models.</p>Results<p>Among 6866 intravenous thrombolysis-treated stroke patients, 5448 (79.3%) had normal haemoglobin level, 1232 (17.9%) anaemia – of those 903 (13.2%) had mild and 329 (4.8%) moderate/severe anaemia – and 186 (2.7%) polyglobulia. Anaemia was associated with poor outcome (OR<sub>adjusted</sub> 1.25 (1.05–1.48)) and mortality (OR<sub>adjusted</sub> 1.58 (1.27–1.95)). In anaemia subgroups, both mild and moderate/severe anaemia independently predicted poor outcome (OR<sub>adjusted</sub> 1.29 (1.07–1.55) and 1.48 (1.09–2.02)) and mortality (OR<sub>adjusted</sub> 1.45 (1.15–1.84) and OR<sub>adjusted</sub> 2.00 (1.46–2.75)). Each haemoglobin level decrease by 1 g/dl independently increased the risk of poor outcome (OR<sub>adjusted</sub> 1.07 (1.02–1.11)) and mortality (OR<sub>adjusted</sub> 1.08 (1.02–1.15)). Anaemia was not associated with occurrence of symptomatic intracranial haemorrhage. Polyglobulia did not change any outcome.</p>Discussion<p>The more severe the anaemia, the higher the probability of poor outcome and death. Severe anaemia might be a target for interventions in hyperacute stroke.</p>Conclusion<p>Anaemia on admission, but not polyglobulia, is a strong and independent predictor of poor outcome and mortality in intravenous thrombolysis-treated stroke patients.</p></div>

Cite this collection

Altersberger, Valerian L; Kellert, Lars; Al Sultan, Abdulaziz S; Martinez-Majander, Nicolas; Hametner, Christian; Eskandari, Ashraf; et al. (2019): Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients. SAGE Journals. Collection. https://doi.org/10.25384/SAGE.c.4738934.v1