Factors Affecting Ischemic Stroke Short-Term Outcome According to Hemoglobin Level
Main Article Content
Abstract
Background and aims There seems to be a U-shaped relation between hemoglobin level and ischemic stroke severity. We aimed to explore possible causes of this relation.
Methods All patients with ischemic stroke between 2006 and 2016 admitted within 3 hours of onset were included. Hemoglobin and NIHSS score were obtained on admission. Modified Rankin Scale (mRS) score was obtained day 7. Locally weighted scatterplot smoothing (lowess smoother) curves displaying the frequencies of M1 occlusion and complications according hemoglobin level on admission and lowess smoother curves displaying mRS day 7 in patients with and without middle cerebral artery (M1) occlusion according to hemoglobin level on admission were obtained.
Results This study includes 905 ischemic stroke patients. Low hemoglobin was associated with pneumonia and urinary tract infection. Neurological worsening was not associated with hemoglobin level. Increasing mRS day 7 was strongly associated with increasing high hemoglobin in patients with M1 occlusion (correlation factor=.61, P=.02).
Conclusions Poor outcome in ischemic stroke patients with low hemoglobin is associated with complications during the hospital stay whereas poor outcome in ischemic stroke patients with increasing high hemoglobin levels is associated with occlusion of the middle cerebral artery.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Kimberly, W.T., et al., Lower hemoglobin correlates with larger stroke volumes in acute ischemic stroke. Cerebrovasc Dis Extra, 2011. 1(1): p. 44-53.
3. Liu, A., et al., Anemia in relation to ischemic stroke outcomes. Life Sci J, 2013. 10(1): p. 3128-3131.
4. Al-Harbi, N., M.S. Alrasheedi, and S.T. Alshammari, Hemoglobin level is associated with severe stroke among stroke patients in Saudi Arabia. Int J Health Sci (Qassim), 2020. 14(5): p. 18-22.
5. Furlan, J.C., J. Fang, and F.L. Silver, Acute ischemic stroke and abnormal blood hemoglobin concentration. Acta Neurol Scand, 2016. 134(2): p. 123-30.
6. Barlas, R.S., et al., Impact of Hemoglobin Levels and Anemia on Mortality in Acute Stroke: Analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis. J Am Heart Assoc, 2016. 5(8).
7. Johnson, C.J., et al., Interrater reliability of an etiologic classification of ischemic stroke. Stroke, 1995. 26(1): p. 46-51.
8. Adams, H.P., Jr., et al., Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke, 1993. 24(1): p. 35-41.
9. Skjelbakken, T., et al., Haemoglobin predicts total mortality in a general young and middle-aged male population. The Tromso Study. Scand J Clin Lab Invest, 2006. 66(7): p. 567-76.