From: Anemia and red blood cell transfusion in neurocritical care
Study | Patients | Design and setting | Exposure | Outcome | Main result | Comment |
---|---|---|---|---|---|---|
Sacco and colleagues [174] | 3481 ischemic stroke | Retrospective (prospective data-base) Multi-center | Baseline hct (patients divided into quartiles) | Death at 28 days | Hct >46% associated with death, but only among women | Hct ≤40% represented lowest quartile; effects of more extreme anemia not reported |
Diamond and colleagues [175] | 1012 ischemic stroke | Retrospective Single-center | Baseline hct Median 41%; inter-quartile range 38 to 44% | Discharge home (rather than nursing facility) | High and low hct associated with worse outcome (U shaped curve) Optimal hct 45% | Only 2% of patients had hct <30% at time of their stroke |
Lowe and colleagues [177] | 270 ischemic stroke | Retrospective Single-center | Baseline hct | Death in hospital | Patients with high hct (≥50%) had higher mortality (66 to 71%) | Elderly (≥75) with hct <40% also had higher mortality (65%) |
Allport and colleagues [178] | 64 hemispheric ischemic stroke | Prospective Single-center | Baseline hct Median 42%; range 33 to 48% | Reperfusion, infarct growth on serial MRI | Higher hct associated with less reperfusion (OR = 0.53, P < 0.0001) and more infarct growth (OR = 1.26, P < 0.05) | This was a study of the effects of high hct; few patients were anemic |
†Huang and colleagues [179] | 774 ischemic stroke | Prospective Single-center | Anemia (Hb <13 g/dl for men, <12 g/dl for women) (21%) | Death and mRS ≥3 at 3 years | Anemic patients more likely to die (OR = 2.2, P = 0.02) and to have a poor neurological outcome (67% vs. 60%, P = 0.07) | Numerous potential confounders not adjusted for; severity of anemia not well characterized |
†Huang and colleagues [180] | 66 ischemic stroke (complicating ICA occlusion) | Prospective Single center | Anemia (Hb <13 for men, <12 for women) | Death or recurrent stroke at 2 years | Anemia associated with death or recurrent stroke at 2 years (OR = 5.1, P = 0.012) | Numerous potential confounders not adjusted for; severity of anemia not well characterized |
Nybo and colleagues [181] | 250 ischemic stroke | Retrospective Single-center | Anemia (Hb <13 g/dl for men, <12 g/dl for women) (15%) | Death at 6 months | Anemia associated with greater risk of death (OR = 3.6, CI = 1.4 to 9.3) | Numerous potential confounders not adjusted for; severity of anemia not well characterized |
Bhatia and colleagues [182] | 116 ischemic or hemorrhagic stroke | Retrospective Single-center | Baseline Hb | Death at 30 days | Hb not associated with risk of death | Degree of anemia relatively mild |
Wade and colleagues [183] | 1377 symptomatic cerebrovascular disease | Retrospective (post hoc review of prospective RCT) Multi-center | Hb >15 g/dl vs. ≥15 g/dl at study entry | Stroke | Patients with Hb ≥15 had similar outcomes to patients with Hb <15 g/dl | This was a study of the effects of high Hb; few patients were anemic |
LaRue and colleagues [184] | 2077 ischemic or hemorrhagic stroke | Retrospective (prospective database) Multi-center | Baseline hct (patients divided into quartiles) | Death in hospital | Hct not predictive of death (neither when high nor low) | Neurologic outcomes (other than death) not reported |