Severe anemia strong predictor of death after stroke, but even slight anemia increases risk
THURSDAY, Feb. 2 (HealthDay News) -- Having anemia can triple the risk of dying within a year after having a stroke, according to a study presented at the American Heart Association's International Stroke Conference, held from Feb. 1 to 3 in New Orleans.
Jason J. Sico, M.D., from the VA Connecticut Healthcare System in West Haven, and colleagues examined medical records to identify 3,965 veterans from 131 Veterans Health Administration facilities who were admitted for a confirmed diagnosis of ischemic stroke in 2007. Women as well as those with incomplete hematocrit (Hct) data, thrombolysis, and inconsistent death dates were excluded. Hct values from 24 hours of admission were categorized into six tiers (≤27 percent, 28 to 32 percent, 33 to 37 percent, 38 to 42 percent, 43 to 47 percent, and ≥48 percent). Anemia and in-hospital, 30-day, 60-day, and one-year mortality were evaluated using multivariate logistic regression models for each time point, adjusting for age, National Institutes of Health Stroke Scale, comorbidity (including pneumonia), and Acute Physiology and Chronic Health Evaluation III scores.
The researchers found that, of the 3,750 patients, 2.1 percent presented with Hct ≤27 percent; 6.2 percent, 28 to 32 percent; 17.9 percent, 33 to 37 percent; 36.4 percent, 38 to 42 percent; 28.2 percent, 43 to 47 percent; and 9.1 percent, ≥48 percent. At all time points, adjusted mortality odds were significantly higher (2.5 to 3.5 times higher) for those with Hct ≤27 percent. Mortality risk at six months and one year showed a significant and dose-response relationship to Hct for all Hct groups <38 percent. High Hcts were independently associated only with in-hospital mortality and only in those with Hct ≥48 percent (odds ratio, 2.9).
"Even a moderate level of anemia is independently associated with an increased risk of death during the first year following acute ischemic stroke," the authors write.
Abstract No. 147