Moderate to Severe Anemia Is Associated with Poor Functional Outcome in Acute Stroke Patients Treated with Mechanical Thrombectomy

Abstract

Background: Anemia will negatively affect cerebral collaterals and penumbra. Eventually, it may cause worse clinical outcomes and even increase mortality rates in stroke patients. Anemia has recently been suggested to be an independent risk factor for ischemic stroke. Therefore, we aimed to investigate the effects of the presence of anemia on clinical outcomes in ischemic stroke patients undergoing mechanical thrombectomy. Methods: This was a retrospective study involving the prospectively and consecutively collected data of 90 adult patients between January 2015 and August 2016. Hemoglobin (Hb) cutoff levels were accepted as 12 g/dL for women and 13 g/dL for men. Patients having anemia were further divided into three subgroups as severe anemia (Hb <8 g/dL for both genders), moderate anemia (Hb <10 g/dL for both genders), and mild anemia (Hb <13 g/dL for men and Hb <12 g/dL for women). Results: Forty of the subjects (44.4%) had anemia. Moderate anemia was detected in 14 out of 90 patients (15.5%) and severe anemia was found in only four of them (4.4%). Poor functional outcome (mRS 3-6) was similar in both anemic and non-anemic patients (37.5% vs. 38%, respectively, p = 0.08), but poor functional outcome was found to be statistically significant with severe anemic group (Hb <8 mg/dL) (p = 0.003). In multiple logistic regression analysis, moderate and severe anemia has been found to increase the mortality (p = 0.032). Conclusions: Our study demonstrated a poor functional outcome only in moderate to severe anemic patients. Clinicians should keep in mind the negative effect of moderate to severe anemia in the clinical course of acute stroke patients treated with mechanical thrombectomy.

Brain atrophy predicts mortality after mechanical thrombectomy of proximal anterior circulation occlusion

“…Our results on the effect of hemoglobin and creatinine are in line and corroborated by previous studies in stroke patients. [29,30] Mortality after MT is still relatively high considering the high reperfusion rates. The full picture of factors contributing to the higher mortality risk despite successful recanalization is unclear.…”

Elevated Red Blood Cell Distribution Width May Be a Novel Independent Predictor of Poor Functional Outcome in Patients Treated with Mechanical Thrombectomy

“…The decision to proceed with thrombectomy as part of the treatment did not influence the administration of IV rt-PA and was based on the identification of a large vessel occlusion on computerized tomographic angiography in patients presenting within 6 hours of the estimated time of onset. Exclusion criteria were as follows: <18 or >82 years, modified Rankin scale (mRS) >2, National Institutes of Health Stroke Scale (NIHSS) >25, malignancy, computerized tomography diagnosis of cerebral hemorrhage, intracerebral mass, or cerebrovascular damage secondary to trauma, presence of hemoglobinopathy (sickle cell anemia, thalassemia), anemias (hemoglobin <10 g/dL), 17 low ejection fraction (<35%), chronic kidney disease (creatinine >2 mg/dL), and posterior circulation large vessel occlusion and evidence of bone marrow insufficiency. RDW levels were measured before mechanical thrombectomy.…”

Intensive Care Management Following Endovascular Clot Retrieval for Acute Stroke: A Systematic Review of the Literature

“…4 As such, 16 clinical studies were included in this review. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The flow of studies and reasons for exclusion are shown in ►Fig. 1.…”