Background
The relationship between anemia and intracerebral hemorrhage is not clear. We investigated
the associations between anemia at the onset and mortality or dependency in patients
with intracerebral hemorrhage (ICH) registered at the China National Stroke Registry
(CNSR).
Methods
The CNSR recruited consecutive patients with diagnoses of ICH in 2007-2008. Their
vascular risk factors, clinical presentations, and outcomes were recorded. The mortality
and dependency at 1, 3, and 6 months and at 1 year were compared between ICH patients
with and without anemia. A favorable outcome was defined as a modified Rankin Scale
(mRS) score of 2 or less and a poor outcome as an mRS score of 3 or more. Multivariable
logistic regression was performed to analyze the association between anemia and the
2 outcomes after adjusting for age, gender, body mass index, history of smoking and
heavy drinking, National Institutes of Health Stroke Scale score on admission, random
glucose value on admission, and hematoma volume.
Results
Anemia was identified in 484 (19%) ICH patients. Compared with ICH patients without
anemia, patients with anemia had no difference in mortality rate at discharge and
at 1 month. The rate of mortality at 3 months, 6 months, 1 year, and dependency at
1 year were significantly higher for those patients with anemia than those without
(P < .05, P < .001, P < .001, and P < .05, respectively). After adjusting for potential confounders, anemia was an independent
risk factor for death at 6 months and 1 year (adjusted odds ratio [OR] = 1.338, 95%
confidence interval 1.01-1.78, and adjusted OR = 1.326, 95% confidence interval 1.00-1.75)
in ICH patients.
Conclusions
Anemia independently predicted mortality at 6 months and 1 year after the initial
episode of intercerebral hemorrhage.
Key Words
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Article info
Publication history
Published online: March 17, 2014
Accepted:
December 16,
2013
Received:
November 20,
2013
Footnotes
Author contributions: Research design: L.-P.L., G.-F.L., C.-X.W., and Y.-J.W.; study conception: X.-Q.Z- and Y.-J.W.; concept development: C.-X.W. and Y.-J.W.; literature review: YJZ, G.-F.L., and Y.-J.W.; data collection: Y.-J.Z., G.-F.L., L.-P.L., and C.-X.W.; data analysis: Y.-J.Z.; statistical consultation: G.-F.L.; drafting the article: Y.-J.Z. and Y.-J.W.; review of submitted versions: Y.-J.Z., G.-F.L., and Y.-J.W.; approval of submitted versions: Y.-J.W.; and draft revisions: Y.-J.W.
This study was funded by the Ministry of Science and Technology and the Ministry of health of the People's Republic of China. The grants include National Science and Technology Major Project of China (2008zx09312-008), The National Science Foundation (grant no. 7102050), The Research Special Fund For Public Welfare Industry of Health (200902004), Beijing Health System High Level Health Technology Talent Cultivation Plan (grant no.2001-3-023), and The Beijing Science and Technology Committee (grant no. D101107049310005 and Z121100005512016) and National Science and Technology Major Project of China (2011BA108B02).
Conflicts of interest: The authors declare no conflict of interest.
Disclosure: The financial sponsors of CNSR had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.020
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
