Acute stroke: decline in Hb could worsen outcomes at discharge

Takeaway

• In patients hospitalised with acute stroke, a decline in Hb level of 2.2 g/dL or higher was associated with poor outcomes at discharge.

Why this matters

• Very little is known about the effect of anaemia during hospitalisation on functional outcomes in patients with acute stroke.

Study design

• Retrospective analysis of 480 consecutive patients with history of acute cerebral infarction and presenting without anaemia.
• Patients were assessed using modified Rankin scale and NIH stroke scale (NIHSS).
• Funding: None disclosed.

Key results

• During admission, the mean Hb level was 14.3±1.3 g/dL, nadir Hb value was 13.1±1.9 g/dL, and the mean decline in Hb level was 1.3±1.5 g/dL.
• Hb level below 1.5 g/dL was found to be a significant predictor of poor outcomes (OR, 2.10; P=.023).
• Overall, poor outcomes were seen in 158 patients, and their median NIHSS score was high, nadir Hb was low, decline in Hb was large, and length of hospital stay was longer (P<.0001 for all).
• A cut-off point of 1.5 g/dL for decline in Hb had a sensitivity of 66.1% and specificity of 87.6% for predicting poor outcomes. The area under the curve was 0.77 (P<.0001).

Limitations

• Retrospective study design