Background and Purpose: Anemia predicts poor clinical outcome of ischemic stroke in the general stroke population. We studied whether this applies to those treated with mechanical thrombectomy for proximal anterior circulation occlusion in the setting of differing collateral circulation. Methods: We collected the data of 347 consecutive anterior circulation stroke patients who underwent mechanical thrombectomy after multimodal CT imaging in a single tertiary stroke care center. Patients with occlusion of the internal carotid artery and/or the first segment of the middle cerebral artery were included. We recorded baseline clinical, laboratory, procedural, and imaging variables, and the technical, imaging, and clinical outcomes. Differences between anemic and nonanemic patients were studied with appropriate statistical tests and binary logistic regression analysis. Results: Ninety-four out of the 285 patients eligible for analysis had anemia, and 243 had fair or good collateral circulation (collateral score, CS, #x3e;0). Fifty-four percent of the patients experienced good 3-month clinical outcome (modified Rankin Scale ≤2). In pooled analyses of the CS 1–4 and 2–4 ranges, nonanemic patients had good clinical outcome significantly more often (p #x3c; 0.001 for both). This effect was not seen in patients with poor collateral circulation (CS = 0). Nonanemic patients had significantly better odds of good clinical outcome (OR = 2.6, 95% CI 1.377–5.030, p = 0.004) in a binary regression model. A 0.1 g/dL increase in hemoglobin improved the odds of good clinical outcome by 2% (OR = 1.02, 95% CI 1.002–1.044, p = 0.03). Conclusions: Low hemoglobin on admission predicts poor clinical outcome in mechanical thrombectomy patients with fair or good collateral circulation.
Cerebrovasc Dis Extra 2020;10:139–147

中文翻译：

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贫血可预测具有公平或良好侧支循环的机械血栓切除术患者的临床结果差

背景与目的：贫血可预测一般性卒中人群缺血性卒中的临床结局较差。我们研究了这是否适用于在不同侧支循环情况下近端前循环闭塞的机械血栓切除术治疗的患者。方法：我们收集了347例连续的前循环卒中患者的数据，这些患者在一个三级卒中治疗中心接受了多模式CT成像后进行了机械血栓切除术。包括颈内动脉和/或大脑中动脉第一节闭塞的患者。我们记录了基线临床，实验室，程序和影像学变量，以及技术，影像学和临床结果。贫血和非贫血患者之间的差异通过适当的统计检验和二元逻辑回归分析进行了研究。结果：在285位符合分析条件的患者中，有94位患有贫血，其中243位有中等或良好的侧支循环（侧支评分，CS，＃x3e; 0）。54％的患者经历了3个月的良好临床预后（改良的Rankin Scale≤2）。在对CS 1-4和2-4范围的汇总分析中，非贫血患者的临床结局明显更高（p＃x3c；两者均为0.001）。在侧支循环不良（CS = 0）的患者中未观察到这种效果。在二元回归模型中，非贫血症患者具有良好临床结果的几率明显更高（OR = 2.6，95％CI 1.377–5.030，p = 0.004）。血红蛋白每增加0.1 g / dL，可改善临床预后的几率提高2％（OR = 1.02，95％CI 1.002–1.044，p = 0.03）。结论：入院时血红蛋白低预示着侧支循环公平或良好的机械血栓切除术患者的临床结局较差。
Cerebrovasc Dis Extra 2020; 10：139–147