Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients
| Autor: | Stefan T. Engelter, Sophie A. van den Berg, Gerli Sibolt, Alessandro Pezzini, Simon Jung, Marjaana Tiainen, Stefania Nannoni, Nicolas Martinez-Majander, Georg Kägi, Abdulaziz S Al Sultan, Lars Kellert, Sami Curtze, Thomas P. Zonneveld, Visnja Padjen, Paul J. Nederkoorn, Andrea Zini, Henrik Gensicke, Christian Hametner, Ashraf Eskandari, Gian M DeMarchis, Philippe Lyrer, Leo H. Bonati, Peter A. Ringleb, Silja Räty, Stefania Maffei, Valerian L Altersberger, Patrik Michel, Mirjam Rachel Heldner, Alexandros A Polymeris, Marcel Arnold |
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| Přispěvatelé: | HUS Neurocenter, Neurologian yksikkö, University of Helsinki, Helsinki University Hospital Area, Department of Neurosciences, Graduate School, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Neurovascular Disorders, Neurology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
EXPRESSION
BLOOD-TRANSFUSION Blood transfusion Stroke patient Anemia Iv thrombolysis CELL TRANSFUSION IMPACT medicine.medical_treatment Haemoglobin levels Anaemia 030204 cardiovascular system & hematology GUIDELINES 3124 Neurology and psychiatry 03 medical and health sciences 0302 clinical medicine Original Research Articles medicine In patient intravenous thrombolysis ANEMIA Stroke RISK business.industry 3112 Neurosciences Thrombolysis medicine.disease haemoglobin stroke 3. Good health IV THROMBOLYSIS polyglobulia Anesthesia TRANSFUSION THRESHOLDS outcome Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Eur Stroke J European Stroke Journal, 5(2), 138-147. SAGE Publications Inc. |
| ISSN: | 2396-9873 |
| DOI: | 10.1177/2396987319889468 |
| Popis: | Introduction 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. Patients and methods 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: 15.5 g/dl; male: >17 g/dl). Anaemia was subdivided into mild and moderate/severe (female/male: Results 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 (ORadjusted 1.25 (1.05–1.48)) and mortality (ORadjusted 1.58 (1.27–1.95)). In anaemia subgroups, both mild and moderate/severe anaemia independently predicted poor outcome (ORadjusted 1.29 (1.07–1.55) and 1.48 (1.09–2.02)) and mortality (ORadjusted 1.45 (1.15–1.84) and ORadjusted 2.00 (1.46–2.75)). Each haemoglobin level decrease by 1 g/dl independently increased the risk of poor outcome (ORadjusted 1.07 (1.02–1.11)) and mortality (ORadjusted 1.08 (1.02–1.15)). Anaemia was not associated with occurrence of symptomatic intracranial haemorrhage. Polyglobulia did not change any outcome. Discussion 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. Conclusion Anaemia on admission, but not polyglobulia, is a strong and independent predictor of poor outcome and mortality in intravenous thrombolysis-treated stroke patients. |
| Databáze: | OpenAIRE |
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