Anemia status, hemoglobin concentration and outcome after acute stroke: a cohort study.
Anemia status, hemoglobin concentration and outcome after acute stroke: a cohort study.
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DOI：
10.1186/1471-2377-10-22
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发表时间：
2010-04-09
期刊：
影响因子：
2.6
通讯作者：
Schwammenthal Y
中科院分区：
文献类型：
--
作者：
Tanne D;Molshatzki N;Merzeliak O;Tsabari R;Toashi M;Schwammenthal Y
在急性中风的情况下，贫血有可能加剧脑缺血，然而，血红蛋白的整个范围与长期结果之间的关系尚不清楚。我们在 859 名连续急性中风（缺血性或脑出血）患者中检查了世界卫生组织定义的入院贫血状态（男性血红蛋白 <13，女性 <12 g/dl）与血红蛋白浓度和 1 年结局之间的关联。平均基线血红蛋白浓度为 13.8 ± 1.7 g/dl（范围 8.1 - 18.7）。 19% 的女性和男性患者存在世界卫生组织定义的贫血症。调整基线特征差异后，入院贫血患者的 1 个月全因死亡调整 OR 为 1.90（95% CI，1.05 至 3.43），1 年调整 OR 为 1.72（95% CI，1.00 至 2.93），残疾、护理机构护理或死亡的综合终点为 2.09（95% CI，1.13 至 2.93）。 3.84) 和 1.83 （95% CI，1.02 至 3.27）。血红蛋白四分位数与全因死亡之间的关系揭示了在低浓度和高浓度极端情况下与风险增加的非线性关联。在为估计血红蛋白与感兴趣结果之间的线性和二次关系而开发的逻辑回归模型中，血红蛋白平方的每个单位增量都与全因死亡的调整后赔率增加相关[1个月时为1.06（1.01至1.12；p = 0.03）； 1 年 1.09（1.04 至 1.15；p < 0.01）]，证实血红蛋白的极端低水平和高水平都与死亡率增加相关。世界卫生组织定义的贫血在男性和女性急性中风患者中都很常见，并且预测预后不佳。此外，入院血红蛋白与死亡率之间并不是线性相关的。血红蛋白的两个极端值都会增加死亡风险。
In the setting of an acute stroke, anemia has the potential to worsen brain ischemia, however, the relationship between the entire range of hemoglobin to long-term outcome is not well understood. We examined the association between World Health Organization-defined admission anemia status (hemoglobin<13 in males, <12 g/dl in women) and hemoglobin concentration and 1-year outcome among 859 consecutive patients with acute stroke (ischemic or intracerebral hemorrhage). The mean baseline hemoglobin concentration was 13.8 ± 1.7 g/dl (range 8.1 - 18.7). WHO-defined anemia was present in 19% of patients among both women and men. After adjustment for differences in baseline characteristics, patients with admission anemia had an adjusted OR for all-cause death at 1-month of 1.90 (95% CI, 1.05 to 3.43) and at 1-year of 1.72 (95% CI, 1.00 to 2.93) and for the combined end-point of disability, nursing facility care or death of 2.09 (95% CI, 1.13 to 3.84) and 1.83 (95% CI, 1.02 to 3.27) respectively. The relationship between hemoglobin quartiles and all-cause death revealed a non-linear association with increased risk at extremes of both low and high concentrations. In logistic regression models developed to estimate the linear and quadratic relation between hemoglobin and outcomes of interest, each unit increment in hemoglobin squared was associated with increased adjusted odds of all-cause death [at 1-month 1.06 (1.01 to 1.12; p = 0.03); at 1-year 1.09 (1.04 to 1.15; p < 0.01)], confirming that extremes of both low and high levels of hemoglobin were associated with increased mortality. WHO-defined anemia was common in both men and women among patients with acute stroke and predicted poor outcome. Moreover, the association between admission hemoglobin and mortality was not linear; risk for death increased at both extremes of hemoglobin.
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影响因子：
--
作者：
Zakai, NA;Katz, R;Cushman, M
通讯作者：
Cushman, M
DOI：
10.1093/gerona/61.5.474
发表时间：
2006-05-01
影响因子：
5.1
作者：
Penninx, Brenda W. J. H.;Pahor, Marco;Guralnik, Jack M.
通讯作者：
Guralnik, Jack M.
影响因子：
1.8
作者：
Irace, C;Ciamei, M;Gnasso, A
通讯作者：
Gnasso, A
影响因子：
3.7
作者：
CLEVELAND, WS;DEVLIN, SJ
通讯作者：
DEVLIN, SJ
DOI：
10.1093/gerona/63.8.873
发表时间：
2008-08-01
影响因子：
5.1
作者：
Dong, XinQi;de Leon, Carlos Mendes;Evans, Denis
通讯作者：
Evans, Denis