Background: Reduced hemoglobin concentration has an adverse impact on the ischemic penumbra in patients with ischemic stroke as it causes reduced oxygen delivery to neuronal tissue and predisposes to infarct expansion. There is a paucity of data on the impact of anemia on early functional outcomes. Aims: To determine the association of anemia on early functional outcomes in a cohort of patients with ischemic stroke. Methods: This prospective study was conducted among 190 participants with acute ischemic stroke presenting to the National Hospital of Sri Lanka. Data were collected on socio-demographic determinants, clinical presentation, co-morbidities, subtype of stroke, and stroke severity (NIHSS score). Early functional outcomes were assessed by the Modified-Rankin-Score (mRS) and Barthel index (BI) within 48 h of the onset. Anemia was defined as Hb <13 g/dl in males and <12 g/dl in females. Results: The mean age of the population was 62.4 years (SD = 11.8). Most participants (75.8%) were males. Anemia was noted in 56.4% of the total study population (59.0% males; 56.5% females) with a mean Hb of 11.7 g/dl. A total of 20% of patients had moderate to severe stroke severity as defined by an NIHSS of ≥16. Functional status assessment revealed that 67.9% had mRS <3 and 85.8% had BI <75. Furthermore, 85.8% had a composite MRS <3 and/or BI 75. Univariate analysis revealed that anemia was significantly associated with “moderate-severe” functional disability. On logistic regression analyses, this retained significance when the functional disability was assessed by mRS >3 (adjusted OR = 2.36; 95% CI = 1.1–5.1). Receiver operator characteristics (ROC) curves indicated a Hb% of 10.65 g/dl as the cut-off that would predict stroke-related disability assessed by mRS >3 [sensitivity = 86.7%; specificity = 34.2%; and AUC = 0.659 (P < 0.0001)]. Conclusions: Anemia is an independent determinant of poor functional disability in early acute ischemic stroke.


中文翻译：

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贫血作为南亚人群缺血性卒中早期功能障碍的预测因子


背景：降低的血红蛋白浓度对缺血性中风患者的缺血半影有不利影响，因为它会导致向神经元组织的氧气输送减少并容易发生梗塞扩大。缺乏关于贫血对早期功能结果影响的数据。目的：在一组缺血性卒中患者中确定贫血与早期功能结果的关系。方法：这项前瞻性研究是在 190 名就诊于斯里兰卡国立医院的急性缺血性卒中参与者中进行的。收集有关社会人口学决定因素、临床表现、合并症、卒中亚型和卒中严重程度（NIHSS 评分）的数据。在发病 48 小时内通过改良 Rankin 评分 (mRS) 和 Barthel 指数 (BI) 评估早期功能结果。贫血定义为男性 Hb <13 g/dl，女性 <12 g/dl。结果：人口的平均年龄为 62.4 岁（SD = 11.8）。大多数参与者（75.8%）是男性。56.4% 的总研究人群（59.0% 男性；56.5% 女性）出现贫血，平均 Hb 为 11.7 g/dl。根据 NIHSS ≥16 的定义，总共 20% 的患者具有中度至重度卒中严重程度。功能状态评估显示 67.9% 的 mRS <3 和 85.8% 的 BI <75。此外，85.8% 的患者的综合 MRS <3 和/或 BI 75。单变量分析显示，贫血与“中重度”功能障碍显着相关。在逻辑回归分析中，当通过 mRS > 3 评估功能障碍时，这仍然具有显着性（调整后的 OR = 2.36；95% CI = 1.1-5.1）。接受者操作者特征 (ROC) 曲线表明 Hb% 为 10。65 g/dl 作为预测由 mRS > 3 评估的中风相关残疾的临界值 [敏感性 = 86.7%；特异性 = 34.2%；和 AUC = 0.659 (P < 0.0001)]。结论：贫血是早期急性缺血性卒中功能障碍的独立决定因素。