Department of Neurology, Sichuan University West China Hospital, Chengdu, China.
State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
BMJ Open. 2022 Jan 4;12(1):e048108. doi: 10.1136/bmjopen-2020-048108.
To examine the association between high haemoglobin levels and outcomes in intracerebral haemorrhage (ICH) in a multicentre cohort study.
Prospective multicentre cohort study.
21 tertiary hospitals across mainland China.
A total of 5318 consecutive in-hospital spontaneous ICH patients were recruited between January 2012 and June 2016.
Haemoglobin levels were measured on admission. Binary or ordinary logistic regression was used to evaluate the independent relationship of haemoglobin level with clinical outcomes at 3 months, measured as death or disability. Restricted cubic spline regression was fitted to examine the potential non-linear shape of the dose-response curve between the whole haemoglobin levels and 3-month poor outcomes.
A total of 5031 patients with ICH were analysed (64.3% male; mean age (SD), 57.8 (15.2) years). We found that the highest haemoglobin quintile was associated with poor outcomes 3 months in males (adjusted OR (aOR) 1.65, 95% CI 1.21 to 2.25) but not in females, which was also observed in the pooled analysis of three subcohorts in male patients (average aOR 1.70, 95% CI 1.23 to 2.33). The spline regression suggested a non-linear association between haemoglobin levels and outcomes and a linear relationship was observed between an elevated haemoglobin level and 3-month disability/death in males (haemoglobin level per 10 g/L: aOR 1.24, 95% CI 1.10 to 1.40, p<0.001), which was mediated by larger haematoma volume (effect size: 0.115, 95% CI 0.012 to 0.231).
This study found a sex-specific association between an elevated haemoglobin level and poor 3-month outcomes, which might be mediated by larger haematoma volume.
在一项多中心队列研究中，研究高血红蛋白水平与颅内出血（ICH）结局之间的关系。
前瞻性多中心队列研究。
中国大陆 21 家三级医院。
共招募了 2012 年 1 月至 2016 年 6 月期间住院的 5318 例自发性 ICH 连续患者。
入院时测量血红蛋白水平。二项或普通逻辑回归用于评估血红蛋白水平与 3 个月时临床结局（死亡或残疾）的独立关系。受限立方样条回归拟合用于检查整个血红蛋白水平与 3 个月不良结局之间潜在的非线性剂量-反应关系曲线。
共分析了 5031 例 ICH 患者（64.3%为男性；平均年龄（标准差）为 57.8（15.2）岁）。我们发现，最高血红蛋白五分位组与男性 3 个月时不良结局相关（调整后的优势比[aOR]1.65，95%置信区间[CI]1.21 至 2.25），但在女性中并非如此，在男性患者的三个亚队列的汇总分析中也观察到了这种情况（平均 aOR 1.70，95%CI 1.23 至 2.33）。样条回归表明血红蛋白水平与结局之间存在非线性关系，在男性中，血红蛋白水平升高与 3 个月残疾/死亡之间存在线性关系（血红蛋白水平每 10g/L：aOR 1.24，95%CI 1.10 至 1.40，p<0.001），这与血肿体积增大有关（效应量：0.115，95%CI 0.012 至 0.231）。
这项研究发现，高血红蛋白水平与 3 个月不良结局之间存在性别特异性关联，这可能与血肿体积增大有关。
