AHA: Anemia may triple stroke mortality

AHA: Anemia May Triple Stroke Mortality
AHA: Anemia May Triple Stroke Mortality

HealthDay News -- Having anemia can triple the risk of dying within a year after having a stroke, according to a study presented at the American Heart Association's 2012 International Stroke Conference in New Orleans.

"Even a moderate level of anemia is independently associated with an increased risk of death during the first year following acute ischemic stroke," according to Jason J. Sico, MD, from the VA Connecticut Healthcare System in West Haven, and colleagues. "Very low or very high Hct is associated with early post-stroke mortality."

They examined the medical records of 3,965 patients from Veterans Health Administration facilities who were admitted for a confirmed diagnosis of ischemic stroke in 2007. Women, as well as those with incomplete hematocrit (Hct) data, thrombolysis and inconsistent death dates were excluded; 3,750 patients were included in the final analysis.

The researchers categorized Hct values from 24 hours of admission into six tiers: those with Hct values ≤27%; those with values between 28% to 32%; 33% to 37%; 38% to 42%; 43% to 47%; and ≥48%. Anemia and in-hospital 30-day, 60-day and one-year mortality were assessed using multivariate logistic regression models for each time point, after adjusting for age, National Institutes of Health Stroke Scale, comorbidity (including pneumonia) and Acute Physiology and Chronic Health Evaluation III scores.

The researchers found that adjusted mortality odds were 2.5 to 3.5 times higher among patients with Hct ≤27% (P values < 0.013 for in-hospital and 30-day mortality; P values at 6 months and one year were 0.002 and 0.001, respectively). 

At six months and one year, mortality risk had a significant dose-response relationship to Hct among all groups with Hct <38%. High Hct values were only independently associated with in-hospital mortality and only among those with Hct values ≥48% (OR=2.9; P=0.004).

"Further work is required to evaluate whether interventions that treat anemia, its complications and underlying etiologies may also reduce post-stroke mortality," the researchers wrote.

Sico JJ et al. Stroke. 2012; 43: A147.

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