Association between admission haematocrit and mortality among men with acute ischaemic stroke  

作　　者：Jason J Sico Laura J Myers Brenda J Fenton John Concato Linda S Williams Dawn M Bravata 

机构地区：[1]Neurology Service,VA Connecticut Healthcare System,West Haven,Connecticut,USA [2]Department of Neurology,Center for NeuroEpidemiological and Clinical Neurological Research,Yale University School of Medicine,New Haven,Connecticut,USA [3]Department of Internal Medicine,Yale University School of Medicine,New Haven,Connecticut,USA [4]Clinical Epidemiology Research Center(CERC),VA Connecticut Healthcare System,West Haven,Connecticut,USA [5]Pain Research,Informatics,Multimorbidities and Education(PRIME)Center of Innovation,VA Connecticut Healthcare System,West Haven,Connecticut,USA [6]Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI),Richard L Roudebush VA Medical Center,Indianapolis,Indiana,USA [7]VA Health Services Research and Development(HSR&D),Center for Healthcare Informatics,Richard L Roudebush VA Medical Center,Indianapolis,Indiana,USA [8]Division of Chronic Disease Epidemiology,Yale School of Public Health,West Haven,Connecticut,USA [9]Medical Service,VA Connecticut Healthcare System,West Haven,Connecticut,USA [10]Regenstrief Institute,Indianapolis,Indiana,USA [11]Department of Neurology,Indiana University School of Medicine,Indianapolis,Indiana,USA [12]Department of Internal Medicine,Indiana University School of Medicine,Indianapolis,Indiana,USA

出　　处：《Stroke & Vascular Neurology》2018年第3期160-168,共9页卒中与血管神经病学（英文）

基　　金：This work was supported by the Department of Veterans Affairs,VHA,Office of Quality and Performance,and Health Services Research&Development Service Quality Enhancement Research Initiative Service Directed Project 12-178 and Career Development Award 11-262,and the Department of Veterans Affairs,Health Services Research&Development,Stroke Quality Enhancement Research Initiative(QUERI)Rapid Response Project 09-184.The views expressed in this article are those of the authors and do not necessarily represent the view of the Department of Veterans Affairs.

摘　　要：Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions;less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke.Methods Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007.Haematocrit values within 24 hours of admission were classified as≤27%,28%-32%,33%-37%,38%-42%,43%-47% or≥48%.Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital,30-day,6-month and 1-year mortality,adjusting for age,medical comorbidities,modified Acute Physiology and Chronic Health Evaluation-III and stroke severity.Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates.results Among n=3750 patients included in the analysis,the haematocrit values were≤27%in 2.1%(n=78),28%-32% in 6.2%(n=234),33%-37%in 17.9%(n=670),38%-42% in 36.4%(n=1366),43%-47% in 28.2%(n=1059)and≥48% in 9.1%(n=343).Patients with haematocrit≤27%,compared with patients in the 38%-42% range,were more likely to have died across all follow-up intervals,with statistically significant adjusted ORs(aORs)ranging from 2.5 to 3.5.Patients with polycythaemia(ie,haematocrit≥48%)were at increased risk of in-hospital mortality(aOR=2.9;95%CI 1.4 to 6.0),compared with patients with mid-range admission haematocrits.Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis.Impact factors in the 1-year mortality model were 0.46(severe anaemia),0.06(cancer)and 0.018(heart disease).Conclusions Anaemia is independently associated with an increased risk of death throughout the first year post stroke;high haematocrit is associated with early poststroke mortality.Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease.These data cannot address the qu

关 键 词：MORTALITY admitted TRANSFUSION 

分 类 号：R73[医药卫生—肿瘤]