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Updated: May 14, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Sex differences and hemoglobin levels in relation to stroke outcomes
W Taylor Kimberly1, Fabricio O Lima, Sydney O'Connor
1Stroke Service and Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. wtkimberly@partners.org
Neurology
|February 1, 2013
Summary
Lower hemoglobin levels in women are linked to worse stroke outcomes. This finding suggests hemoglobin may explain sex differences in stroke recovery, highlighting a potential modifiable factor for improved patient care.
Area of Science:
- Neurology
- Hematology
- Public Health
Background:
- Stroke outcomes are demonstrably worse in women compared to men.
- Women typically exhibit lower hemoglobin levels than men, prompting investigation into this physiological difference.
Purpose of the Study:
- To investigate the association between hemoglobin levels and stroke outcomes in women.
- To determine if hemoglobin levels mediate the observed sex differences in stroke outcomes.
Main Methods:
- Retrospective analysis of 274 patients from a prospective multicenter study.
- Utilized the modified Rankin Scale (mRS) to assess clinical outcomes at 6 months post-stroke.
- Employed ordinal logistic regression to evaluate the independent effect of hemoglobin on outcomes and its interaction with sex.
Main Results:
- Women presented with lower mean hemoglobin levels (11.7 ± 1.8 g/dL) versus men (13.3 ± 1.7 g/dL).
- Low hemoglobin was significantly associated with poorer 6-month mRS outcomes (p < 0.001) in univariate analysis.
- Hemoglobin remained an independent predictor of poor stroke outcome after adjusting for covariates, and its inclusion attenuated the independent effect of sex on outcome.
Conclusions:
- Sex disparities in stroke outcomes appear to be significantly influenced by lower hemoglobin levels, which are more common in women.
- Hemoglobin represents a potentially modifiable factor warranting further investigation for improving stroke care and outcomes in women.
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