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Anemia in young patients with ischaemic stroke
L Kellert1, M Kloss, A Pezzini
1Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany; Department of Neurology, University Hospital, Ludwig Maximilian University, Munich, Germany.
Insights
Anemia on admission is linked to more severe strokes in patients with cervical artery dissection or other causes. Moderate to severe anemia may predict a worse functional outcome after stroke.
Area of Science:
- Neurology
- Hematology
- Clinical Medicine
Background:
- Anemia is a common condition with potential implications for various medical outcomes.
- The relationship between anemia and stroke, particularly in specific etiological subgroups, requires further investigation.
Purpose of the Study:
- To examine the association between admission anemia and ischemic stroke (IS).
- To assess the impact of anemia on stroke severity and early functional outcomes in patients with cervical artery dissection (CeAD) and non-CeAD IS.
Main Methods:
- A cohort of 1206 patients from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) study was analyzed.
- Anemia was defined by hemoglobin levels, and stroke severity was measured using the National Institutes of Health Stroke Scale (NIHSS).
- Functional outcome at 3 months was assessed using the modified Rankin Scale (mRS-3mo).
Main Results:
- Anemia was present in 7.2% of patients and was associated with female sex.
- Anemia correlated with stroke occurrence in CeAD patients and with increased stroke severity in both CeAD and non-CeAD groups.
- Moderate to severe anemia was significantly associated with unfavorable functional outcomes (mRS-3mo ≥ 3).
Conclusions:
- Admission anemia is associated with stroke in CeAD patients and more severe strokes in IS patients.
- Moderate to severe anemia may serve as a predictor of unfavorable functional outcomes post-stroke.
Background And Purpose:
To investigate the association of anemia on admission with ischaemic stroke (IS), stroke severity and early functional outcome in patients with cervical artery dissection (CeAD) or with IS of other causes (non-CeAD-IS patients).
Methods:
The study sample comprised all patients from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) study without pre-existing disability and with documentation of stroke severity and hemoglobin (Hb) concentration on admission. Anemia was classified as mild (Hb < 12 g/dl in women and Hb < 13 g/dl in men) or moderate to severe (Hb < 10 g/dl in women and Hb < 11 g/dl in men). Stroke severity on admission was assessed with the National Institutes of Health Stroke Scale (NIHSS). Outcome after 3 months was assessed with the modified Rankin Scale (mRS-3mo). Unfavorable outcome was defined as mRS-3mo ≥ 3.
Results:
Amongst 1206 study patients (691 CeAD and 515 non-CeAD), 87 (7.2%) had anemia, which was moderate to severe in 18 (1.5%) patients. Anemia was associated with female sex in both study samples, but no further associations with risk factors or comorbidities were observed. In CeAD patients, anemia was associated with occurrence of stroke (P = 0.042). In both study samples, anemic patients had more severe strokes (CeAD, P = 0.023; non-CeAD, P = 0.005). Functional outcome was not associated with anemia in general, but moderate to severe anemia was significantly associated with unfavorable outcome (P = 0.004).
Conclusion:
Anemia on admission was associated with stroke in CeAD patients and with more severe strokes in both study samples. Moderate to severe anemia may predict unfavorable outcome.
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