Related Experiment Video
Updated: May 21, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Anemia and elevated hemoglobin in stroke patients treated with thrombectomy - a cohort study from the EndoVAscular
Valerian L Altersberger1, Morin Beyeler2, Katarina Jood3
1Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
Background:
Anemia and elevated hemoglobin levels (HLs) are frequently found in ischemic stroke patients, and their prognostic meaning is unclear.
Objectives:
We aimed to study the effect of HLs on the functional outcome and risk of symptomatic intracranial hemorrhage (sICH) in stroke patients treated with thrombectomy.
Methods:
In this prospective multicenter study of the EndoVAscular Treatment and ThRombolysis for Ischemic Stroke Patients Registry, we investigated whether HLs were associated with 3-month poor outcomes (modified Rankin Scale 3-6), mortality, and sICH. HLs were categorized into anemia (<120 g/L; moderate/severe anemia: <100 g/L), normal HL (female: 120-155 g/L; male: 120-170 g/L), and elevated HL (female: >155 g/L; male: >170 g/L). Unadjusted and adjusted odds ratios (ORsadjusted) with 95% CIs were calculated from logistic regression models. Additionally, we calculated fitted conditional mean outcomes for HLs as a continuous variable.
Results:
Among 9967 endovascular thrombectomy-treated patients, 7168 (71.9%) had normal HLs, 2496 (25.1%) had anemia (of whom 618 [6.2%] had moderate/severe anemia), and 303 (3%) had elevated HLs. Anemia vs normal HLs was independently associated with a poor outcome (ORadjusted 1.48 [95% CI, 1.32-1.66]) and mortality (ORadjusted 1.69 [95% CI, 1.50-1.90]). Moderate/severe anemia had the highest odds of a poor outcome (ORadjusted 1.75 [95% CI, 1.41-2.18]) and mortality (ORadjusted 2.80 [95% CI, 2.28-3.43]). Elevated HLs vs normal HLs were independently associated with a poor outcome (ORadjusted 1.33 [95% CI, 1.01-1.74]) and mortality (ORadjusted 1.49 [95% CI, 1.09-2.03]). HLs were not associated with the occurrence of sICH. HL, as a continuous variable, showed a U-shaped relationship with mortality and poor outcomes.
Conclusion:
More severe anemia and higher HLs are associated with increased likelihood of poor functional outcome and death. They may constitute targets for interventions to improve outcomes.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Ischemic Stroke l: Introduction
Ischemic Stroke ll: Pathophysiology
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

