Rutgers New Jersey Medical School, Newark, NJ, USA.
Clin Neurol Neurosurg. 2021 Dec;211:107028. doi: 10.1016/j.clineuro.2021.107028. Epub 2021 Nov 11.
Anemia at presentation is associated with worse outcomes in patients with acute ischemic stroke (AIS). We aim to investigate the association of anemia parameters with functional dependence and mortality in patients who undergo mechanical thrombectomy (MT).
We performed a retrospective chart review of patients who underwent MT for an anterior circulation large vessel occlusion at a comprehensive stroke center from 1/2015-6/2020. Anemia was considered as a dichotomous categorical variable with a cutoff point of hemoglobin (Hb) < 12.0 g/dL in women and < 13.0 g/dL in men, as per the definition of the World Health Organization. Mean values of Hb and hematocrit (HCT) were obtained over the first five days of admission. Hemoglobin and HCT variability were measured using standard deviation (SD), and coefficient variability (CV) over the first five days of admission. Values of variance and difference (the difference between peak and trough of Hemoglobin or HCT) were also recorded. Multivariate logistic regression analyses were performed, including the predictor variables which were contributing significantly to the model (P < 0.05) in the univariate analysis, with 30-day functional dependence (mRS 3-6) (primary outcome) and 30-day mortality (secondary outcome) as the dependent variables.
188 patients met our inclusion criteria. Anemia on presentation, lower mean and minimum values of five-day Hb and HCT, and higher variability in five-day Hb and HCT parameters were associated with higher 3-month mortality. Men with lower mean and minimum values of five-day Hb and HCT had a significantly higher likelihood of functional dependence at 3-months. This finding was not replicated amongst women in our cohort.
Our study demonstrated higher 3-mortality in patients with anemia and Hb variability. Our study also demonstrated a higher likelihood of functional dependence in patients amongst men with anemia.
在急性缺血性脑卒中（AIS）患者中，就诊时的贫血与预后不良相关。我们旨在研究机械血栓切除术（MT）后患者的贫血参数与功能依赖和死亡率之间的关系。
我们对在综合卒中中心接受前循环大血管闭塞 MT 的患者进行了回顾性病历审查，研究时间为 2015 年 1 月至 2020 年 6 月。根据世界卫生组织的定义，贫血被视为二分类分类变量，血红蛋白（Hb）<12.0 g/dL 的女性和<13.0 g/dL 的男性。入院前五天内获得 Hb 和血细胞比容（HCT）的平均值。使用入院前五天的标准差（SD）和变异系数（CV）来测量 Hb 和 HCT 的变化。还记录了方差和差异（Hb 或 HCT 的峰值与谷值之间的差异）的值。进行多变量逻辑回归分析，包括在单变量分析中对模型有显著贡献的预测变量（P<0.05），以 30 天功能依赖（mRS 3-6）（主要结局）和 30 天死亡率（次要结局）为因变量。
188 名患者符合我们的纳入标准。就诊时的贫血、五天 Hb 和 HCT 的平均值和最低值较低以及五天 Hb 和 HCT 参数的变异性较高与较高的 3 个月死亡率相关。入院前五天 Hb 和 HCT 平均值和最低值较低的男性在 3 个月时功能依赖的可能性显著更高。在我们的队列中，女性中没有发现这种情况。
我们的研究表明，贫血和 Hb 变异性较高的患者 3 个月死亡率较高。我们的研究还表明，贫血男性患者功能依赖的可能性更高。
