Impact of anemia on in‐hospital complications after ischemic stroke

Wei, Chuanliang; Zhang, S.-T.; Tan, Ge; Zhang, S.-H.; Liu, M.

doi:10.1111/ene.13595

Cited by 18 publications

(16 citation statements)

References 28 publications

(38 reference statements)

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“…Anaemia has been an independent risk factor for adverse outcomes in various diseases, including pneumonia, stroke, and heart failure [28,29] . It has been proven thatpneumonia patients with anaemiaare at greater risk of poor outcomes and nosocomial infections in community-acquired pneumonia,and in uenza A [6,7,30] .…”

Section: Discussionmentioning

confidence: 99%

Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

Tao

et al. 2020

Preprint

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Abstract Background and objective:Anaemia commonly aggravates the severity of respiratory diseases, whereas thus far, no study has elucidated the impact of anaemiaonCorona Virus Disease 2019(COVID-19). The aim of this study was to evaluate the clinical characteristics of patients with anaemia, and to further explore the relationship between anaemiaand the severity of COVID-19.METHODS:In this single-center, retrospective, observational study, a total of 222 patients were recruited, including 79 patients with anaemia and 143 patients without anaemia. Clinical characteristics, laboratory findings, disease progression and prognosis were collected and analyzed. Risk factors associated with the severe illness in COVID-19were established by univariable and multivariable logistic regression models.Result：In our cohort, compared to patients without anaemia, patients with anaemia were more likely to experience one or more comorbidities and severe COVID-19 illness, as well as higher mortality. More patients demonstrated elevated levels of C-reactive protein (CRP), procalcitonin(PCT) and creatinine in anaemia group. Levels of erythrocyte sedimentation rate(ESR), D-dimer, myoglobin, T-pro brain natriuretic peptide(T-pro-BNP) and urea nitrogen(BUN)in patients with anaemia were significantly higher than those without. In addition,the proportion of patients with dyspnoea，elevated CRP and PCT was positively associated with the severity of anaemia. The Odd Ratio (OR) of anaemia related to the severe condition of COVID-19 was 5.07 (95% CI:1.82-14.18, P=0.002) and 3.47 (95% CI:1.02-11.75, P=0.046) after adjustment for baseline date and laboratory indices, respectively.Conclusion:Anaemia is an independent risk factor associated with the severe illness of COVID-19, and healthcare professionals should be more sensitive to the haemoglobin levels of COVID-19 patients on admission. To avoid rapid deterioration, more intensive care should be given to patients with anaemia.Trial registration: Ethics committee of Wuhan University People's Hospital (wdry2020-k064)

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Section: Discussionmentioning

confidence: 99%

Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

Tao

et al. 2020

Preprint

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“…The frequent presence of chronic kidney disease, increased systemic inflammation, iron deficiency, insufficient levels of erythropoietin, bone marrow unresponsiveness and the effect of chronic medical therapy may lead to this fact [ [22] , [23] , [24] , [25] ]. Anemia could lead to decreased oxygen delivery and, subsequently, aggravation of symptoms such as dyspnea and fatigue, and thus further impair exercise tolerance and quality of life, prompting hospital admission [ 16 , 26 ]. In a large meta-analysis with 153,180 patients with HF, the crude mortality risk of anemia had an odds ratio of 1.96 (95% confidence interval: 1.74 to 2.21), and the adjusted hazard ratio was 1.46 (95% confidence interval: 1.26 to 1.69), with no difference between patients with a reduced or preserved LVEF [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Significant drop in Hb over 3 g/dL and/or requiring transfusion of blood products without apparent source of bleeding was defined as obscure bleeding [ 13 ]. Anemia was defined by the WHO definitions as Hb < 12 g/dL in woman and Hb < 13 g/dL in men [ 16 ]. CHA 2 DS 2 VASc [ 17 ] and HAS-BLED [ 18 ] scores were used to assess thromboembolic and hemorrhagic risks in the subgroup of patients with AF.…”

Section: Methodsmentioning

confidence: 99%

Incidence and prognostic implications of late bleeding events after percutaneous mitral valve repair

Benito‐González

Estévez‐Loureiro

Prado

et al. 2018

IJC Heart & Vasculature

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ObjectivesMitraClip is an established therapy for patients with mitral regurgitation (MR) that are considered of high-risk or inoperable. However, late bleeding events (BE) after hospital discharge and their impact on prognosis in this cohort of patients have been poorly investigated. Our purpose is to address the incidence, related factors and clinical implications of BE after hospital discharge in patients treated with MitraClip.MethodsProspective registry of all consecutive patients (n = 80) who underwent MitraClip implantation in our Institution between June 2014 and December 2017. BE were defined according to MVARC definitions. A combined clinical end-point including admission for heart failure (HF) and all-cause mortality was established to analyze prognostic implications of BE.ResultsDuring a median follow up of 523.5 days, 41 BE were reported in 21 patients. Atrial fibrillation (AF, HR 4.54, CI95% 1.20–17.10) and combined antithrombotic therapy at discharge (HR 3.52, CI95% 1.03–11.34) were independently associated with BE. In the study period, 15 (18.8%) patients died, 20 (25%) were admitted for HF and 29 (36.3%) presented the combined end-point. After multivariable adjustment BE remained independently associated with an adverse outcome (HR 3.80, CI 95% 1.66–8.72). In the subgroup of patients with AF, HAS-BLED score was higher among subjects with BE (3.1 ± 1.3 vs 2.1 ± 0.9, p = 0.003). HAS-BLED score had a significant discrimination power for the occurrence BE (AUC: 0.677 [0.507–0.848]) in this subgroup.ConclusionsBE are common after MitraClip and are associated with an impaired outcome. Strategies to reduce bleeding events are paramount in this cohort of patients.

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“…Functional failure was defined as the suboptimal result of PMVR during follow up (residual or recurrent MR 3+ or 4+ and/or transmitral mean gradient ≥ 5 mmHg). Anemia was defined according to the World Health Organization as a concentration of serum hemoglobin < 12 g/dL in women and < 13 g/dL in men [9] . A composite primary endpoint of readmission for HF and all-cause death was established to define the prognostic impact of frailty in this series.…”

Section: Study Outcomesmentioning

confidence: 99%

The prognostic impact of frailty in patients undergoing percutaneous mitral valve repair

Benito‐González¹,

Estévez‐Loureiro²,

Castillo³

et al. 2020

MIS

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Aim: Percutaneous mitral valve repair (PMVR) with MitraClip® has proven to be an effective therapy to reduce mitral regurgitation in patients at high risk for conventional surgery. This population is currently characterized by advance age and high prevalence of comorbidities. Our aim was to evaluate the prevalence of frailty in a cohort of patients undergoing PMVR and its impact on clinical outcomes during follow-up. Methods: A prospective registry was performed including all consecutive patients who underwent elective PMVR between June 2014 and March 2018 in our institution. Frailty was evaluated at admission with the functional FRAIL scale. In-hospital and 30-day procedural outcomes were collected. Clinical follow up was carried out including New York Heart Association (NYHA) functional class, heart failure hospitalization and death. Results: Overall, 70 patients were included (mean age 75.3 ± 9.9 years, 65.7% male). Among them, 27 patients (38.6%) had a pre-procedural FRAIL score greater than 2, meeting frailty criteria. No differences between frail and non-frail patients were found in technical success (P = 1.0) or 30-day device success (P = 0.739). At six months follow up, both groups showed a significant improvement in NYHA functional class compared to baseline (frail: P = 0.002; non-frail: P < 0.001). During a median follow up of 675 (range 416-976) days, frailty patients had a higher incidence of HF admission and all-cause mortality (P = 0.013). In multivariate COX regression analysis, FRAIL score greater than 2 was significantly related to the primary composite endpoint (HR = 2.45; 95%CI: 1.02-5.88; P = 0.044).

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Impact of anemia on in‐hospital complications after ischemic stroke

Cited by 18 publications

References 28 publications

Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

Incidence and prognostic implications of late bleeding events after percutaneous mitral valve repair

The prognostic impact of frailty in patients undergoing percutaneous mitral valve repair

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