国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack

第一作者：Runhua Zhang

通讯作者：Gaifen Liu

anemia functional outcome hemoglobin mortality recurrence stroke

基本信息

  • 负责人：Runhua Zhang
  • 数据来源： CNSR-Ⅲ
  • 论文编号：CNSR-Ⅲ20210034
  • 发表时间：2021-11-30

2021-11-30

已发表文章

发表杂志：JAHA

发表类型: Original Contributions

影响因子(IF): 5.5

PMID: 34845923 Pubmed原文链接 全文下载

主要研究背景及目的

People with low hemoglobin or anemia are more frailty. Low hemoglobin and anemia can increase the risk of stroke. Additionally, anemia may increase of infarct volumes and velocity of infarct growth. Whether low hemoglobin concentration was associated with the outcome in population with stroke? Several studies have demonstrated hemoglobin is associated with all-cause mortality after stroke. However, the data regarding the hemoglobin and functional outcome and recurrent stroke after acute stroke are limited and controversial. In this study, we aimed to estimate the association between hemoglobin concentration and stroke severity and functional outcome and recurrent stroke.

方法

We included the patients diagnosed with acute ischemic stroke or transient ischemic attack from the Third China National Stroke Registry. We used the Cox model for mortality, stroke recurrence, and composite vascular events and the logistic model for the poor functional outcome to examine the relationship between hemoglobin and clinical outcomes. In addition, we used the restricted cubic spline to evaluate the nonlinear relationship.

结论

Abnormal hemoglobin was associated with a higher risk of all-cause mortality, poor functional outcome, stroke recurrence, and composite vascular events. More well-designed clinical studies are needed to confirm the relationship between hemoglobin and clinical outcomes after stroke.

主要结果

This study included 14 159 patients with acute ischemic stroke or transient ischemic attack. After adjusted for potential cofounders, both anemia and high hemoglobin were associated with the higher risk of mortality (hazard ratio [HR], 1.73; 95% CI, 1.39–2.15; HR, 2.71; 95% CI, 1.95–3.76) and poor functional outcome (odds ratio [OR], 1.36; 95% CI, 1.18–1.57; OR, 1.42; 95% CI, 1.07–1.87). High hemoglobin, but not anemia, increased the risk of stroke recurrence (HR, 1.37; 95% CI, 1.05–1.79) and composite vascular events (HR, 1.41; 95% CI, 1.08–1.83). There was a U-shaped relationship between hemoglobin and mortality and poor functional outcome.