Abstract
Background and Purpose: Although both ends of the hemoglobin range may negatively influence clinical outcomes in acute ischemic stroke, most studies have examined the linear relationship or focused on the lower end of the range. Furthermore, it is unclear whether hemoglobin concentrations at different time points during hospitalization correlate with clinical outcomes in the same manner. Methods: We identified 2681 consecutive patients with acute ischemic stroke from a prospective stroke registry database and grouped them into hemoglobin concentration quintiles using the following 5 indices: initial, nadir, time-averaged, discharge hemoglobin, and hemoglobin drop. To examine the effect of both ends of hemoglobin range, the third quintile was selected as a reference category except for hemoglobin drop, for which the first quintile was used. As outcome variables, 3-month modified Rankin Scale as an ordinal scale and 3-month mortality were used. Results: With respect to higher modified Rankin Scale scores, the adjusted odds ratios and 95% confidence intervals of the first quintiles of initial, nadir, time-averaged, and discharge hemoglobin were 1.74 (1.31-2.31), 2.64 (2.09-3.33), 1.81 (1.42-2.30), and 1.65 (1.29-2.13), respectively. The opposite ends of these hemoglobin indices were not significantly associated. The adjusted odds ratio of the fifth quintile of hemoglobin drop (greatest hemoglobin drop) was 2.09 (1.51-2.89). The mortality analysis showed similar results except for initial hemoglobin. Conclusions: In acute ischemic stroke, poor outcome was related to the lower but not the higher end of the hemoglobin range, regardless of when and how hemoglobin concentrations were measured.
| Original language | English |
|---|---|
| Pages (from-to) | 3220-3222 |
| Number of pages | 3 |
| Journal | Stroke |
| Volume | 44 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2013 Nov 1 |
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Keywords
- Cerebral infarction
- Functional outcome
- Hemoglobins
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialised Nursing
Cite this
Impact of both ends of the hemoglobin range on clinical outcomes in acute ischemic stroke. / Park, Young Ho; Kim, Beom Joon; Kim, Jun Soon; Yang, Mi Hwa; Jang, Myung Suk; Kim, Nayoung; Han, Moon Ku; Lee, Ji Sung; Lee, Juneyoung; Kim, Sang Yun; Bae, Hee Joon.
In: Stroke, Vol. 44, No. 11, 01.11.2013, p. 3220-3222.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of both ends of the hemoglobin range on clinical outcomes in acute ischemic stroke
AU - Park, Young Ho
AU - Kim, Beom Joon
AU - Kim, Jun Soon
AU - Yang, Mi Hwa
AU - Jang, Myung Suk
AU - Kim, Nayoung
AU - Han, Moon Ku
AU - Lee, Ji Sung
AU - Lee, Juneyoung
AU - Kim, Sang Yun
AU - Bae, Hee Joon
PY - 2013/11/1
Y1 - 2013/11/1
N2 - Background and Purpose: Although both ends of the hemoglobin range may negatively influence clinical outcomes in acute ischemic stroke, most studies have examined the linear relationship or focused on the lower end of the range. Furthermore, it is unclear whether hemoglobin concentrations at different time points during hospitalization correlate with clinical outcomes in the same manner. Methods: We identified 2681 consecutive patients with acute ischemic stroke from a prospective stroke registry database and grouped them into hemoglobin concentration quintiles using the following 5 indices: initial, nadir, time-averaged, discharge hemoglobin, and hemoglobin drop. To examine the effect of both ends of hemoglobin range, the third quintile was selected as a reference category except for hemoglobin drop, for which the first quintile was used. As outcome variables, 3-month modified Rankin Scale as an ordinal scale and 3-month mortality were used. Results: With respect to higher modified Rankin Scale scores, the adjusted odds ratios and 95% confidence intervals of the first quintiles of initial, nadir, time-averaged, and discharge hemoglobin were 1.74 (1.31-2.31), 2.64 (2.09-3.33), 1.81 (1.42-2.30), and 1.65 (1.29-2.13), respectively. The opposite ends of these hemoglobin indices were not significantly associated. The adjusted odds ratio of the fifth quintile of hemoglobin drop (greatest hemoglobin drop) was 2.09 (1.51-2.89). The mortality analysis showed similar results except for initial hemoglobin. Conclusions: In acute ischemic stroke, poor outcome was related to the lower but not the higher end of the hemoglobin range, regardless of when and how hemoglobin concentrations were measured.
AB - Background and Purpose: Although both ends of the hemoglobin range may negatively influence clinical outcomes in acute ischemic stroke, most studies have examined the linear relationship or focused on the lower end of the range. Furthermore, it is unclear whether hemoglobin concentrations at different time points during hospitalization correlate with clinical outcomes in the same manner. Methods: We identified 2681 consecutive patients with acute ischemic stroke from a prospective stroke registry database and grouped them into hemoglobin concentration quintiles using the following 5 indices: initial, nadir, time-averaged, discharge hemoglobin, and hemoglobin drop. To examine the effect of both ends of hemoglobin range, the third quintile was selected as a reference category except for hemoglobin drop, for which the first quintile was used. As outcome variables, 3-month modified Rankin Scale as an ordinal scale and 3-month mortality were used. Results: With respect to higher modified Rankin Scale scores, the adjusted odds ratios and 95% confidence intervals of the first quintiles of initial, nadir, time-averaged, and discharge hemoglobin were 1.74 (1.31-2.31), 2.64 (2.09-3.33), 1.81 (1.42-2.30), and 1.65 (1.29-2.13), respectively. The opposite ends of these hemoglobin indices were not significantly associated. The adjusted odds ratio of the fifth quintile of hemoglobin drop (greatest hemoglobin drop) was 2.09 (1.51-2.89). The mortality analysis showed similar results except for initial hemoglobin. Conclusions: In acute ischemic stroke, poor outcome was related to the lower but not the higher end of the hemoglobin range, regardless of when and how hemoglobin concentrations were measured.
KW - Cerebral infarction
KW - Functional outcome
KW - Hemoglobins
UR - http://www.scopus.com/inward/record.url?scp=84888260283&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84888260283&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.113.002672
DO - 10.1161/STROKEAHA.113.002672
M3 - Article
C2 - 24003047
AN - SCOPUS:84888260283
VL - 44
SP - 3220
EP - 3222
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 11
ER -