Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450052, Henan Province, China.
Neurocrit Care. 2018 Dec;29(3):463-468. doi: 10.1007/s12028-018-0544-6.
Anemia is associated with unfavorable functional outcome in ischemic and hemorrhagic stroke. However, the relationship between anemia and prognosis in patients with cerebral venous thrombosis (CVT) has not been studied.
Consecutive CVT patients were retrospectively identified from November 2011, through January 2017. Anemia was defined according to the World Health Organization criteria (non-pregnant female hemoglobin level < 120 g/L, pregnant female < 110 g/L and male < 130 g/L), which was further classified as mild, moderate, and severe anemia according to hemoglobin concentration, and as microcytic, normocytic, and macrocytic anemia according to mean corpuscular volume. Unfavorable outcome was defined as modified Rankin Scale (mRS) of 3-6. Factors such as age, sex, coma, malignancy, intracerebral hemorrhage, and straight sinus and/or deep CVT involved, premorbid mRS were adjusted to evaluate the relationship between anemia and prognosis in CVT patients.
A total of 238 CVT patients were included, among whom 73 patients (30.67%) were diagnosed with anemia. Multivariate logistic regression analysis showed that patients with anemia had a higher risk of mRS of 3-6 (OR = 3.62; 95% CI, 1.45-9.01; P = 0.006) and mortality (OR = 5.46; 95% CI, 1.90-15.70; P = 0.002). Subgroup analysis showed that severe anemia was independently associated with mRS of 3-6 (OR = 8.80; 95% CI, 1.90-40.81; P = 0.005) and mortality (OR = 9.82; 95% CI, 1.81-53.25; P = 0.010). Similarly, microcytic anemia increased the risk of mRS of 3-6 (OR = 4.64; 95% CI, 1.48-14.52; P = 0.008) and mortality (OR = 9.68; 95% CI, 2.61-35.91; P = 0.001). In addition, our study also revealed that lower hemoglobin level, evaluated as a continuous variable, was inversely associated with mRS of 3-6 (OR = 0.98; 95% CI, 0.96-0.99; P = 0.007) and mortality (OR = 0.97; 95% CI, 0.95-0.99; P = 0.005).
Anemia was a significant and independent predictor of unfavorable functional outcome in patients with CVT.
贫血与缺血性和出血性中风的不良功能结局相关。然而,贫血与脑静脉血栓形成(CVT)患者预后之间的关系尚未研究。
从 2011 年 11 月至 2017 年 1 月,连续回顾性确定 CVT 患者。根据世界卫生组织标准(非妊娠女性血红蛋白水平<120g/L,妊娠女性<110g/L,男性<130g/L)定义贫血,根据血红蛋白浓度进一步将贫血分为轻度、中度和重度贫血,并根据平均红细胞体积将贫血分为小细胞、正细胞和大细胞贫血。不良结局定义为改良 Rankin 量表(mRS)的 3-6 分。调整年龄、性别、昏迷、恶性肿瘤、脑内出血和直窦及/或深部 CVT 受累、发病前 mRS 等因素,评估贫血与 CVT 患者预后的关系。
共纳入 238 例 CVT 患者,其中 73 例(30.67%)诊断为贫血。多变量 logistic 回归分析显示,贫血患者 mRS 为 3-6 分的风险更高(OR=3.62;95%CI,1.45-9.01;P=0.006)和死亡率(OR=5.46;95%CI,1.90-15.70;P=0.002)。亚组分析显示,重度贫血与 mRS 为 3-6 分(OR=8.80;95%CI,1.90-40.81;P=0.005)和死亡率(OR=9.82;95%CI,1.81-53.25;P=0.010)独立相关。同样,小细胞贫血增加 mRS 为 3-6 分(OR=4.64;95%CI,1.48-14.52;P=0.008)和死亡率(OR=9.68;95%CI,2.61-35.91;P=0.001)的风险。此外,我们的研究还表明,血红蛋白水平较低(作为连续变量评估)与 mRS 为 3-6 分(OR=0.98;95%CI,0.96-0.99;P=0.007)和死亡率(OR=0.97;95%CI,0.95-0.99;P=0.005)呈负相关。
贫血是 CVT 患者不良功能结局的显著且独立的预测因素。