Long-Term Outcomes in Patients with Anemia And Cerebral Venous Thrombosis
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Anemia is associated with unfavorable functional outcome in ischemic and hemorrhagic stroke. However, the relationship between anemia and prognosis in patients with cerebral venous thrombosis (CVT) has not been studied.
Consecutive CVT patients were retrospectively identified from November 2011, through January 2017. Anemia was defined according to the World Health Organization criteria (non-pregnant female hemoglobin level < 120 g/L, pregnant female < 110 g/L and male < 130 g/L), which was further classified as mild, moderate, and severe anemia according to hemoglobin concentration, and as microcytic, normocytic, and macrocytic anemia according to mean corpuscular volume. Unfavorable outcome was defined as modified Rankin Scale (mRS) of 3–6. Factors such as age, sex, coma, malignancy, intracerebral hemorrhage, and straight sinus and/or deep CVT involved, premorbid mRS were adjusted to evaluate the relationship between anemia and prognosis in CVT patients.
A total of 238 CVT patients were included, among whom 73 patients (30.67%) were diagnosed with anemia. Multivariate logistic regression analysis showed that patients with anemia had a higher risk of mRS of 3–6 (OR = 3.62; 95% CI, 1.45–9.01; P = 0.006) and mortality (OR = 5.46; 95% CI, 1.90–15.70; P = 0.002). Subgroup analysis showed that severe anemia was independently associated with mRS of 3–6 (OR = 8.80; 95% CI, 1.90–40.81; P = 0.005) and mortality (OR = 9.82; 95% CI, 1.81–53.25; P = 0.010). Similarly, microcytic anemia increased the risk of mRS of 3–6 (OR = 4.64; 95% CI, 1.48–14.52; P = 0.008) and mortality (OR = 9.68; 95% CI, 2.61–35.91; P = 0.001). In addition, our study also revealed that lower hemoglobin level, evaluated as a continuous variable, was inversely associated with mRS of 3–6 (OR = 0.98; 95% CI, 0.96–0.99; P = 0.007) and mortality (OR = 0.97; 95% CI, 0.95–0.99; P = 0.005).
Anemia was a significant and independent predictor of unfavorable functional outcome in patients with CVT.
KeywordsCerebral venous thrombosis Anemia Prognosis Mortality Risk factors
We thank Wang Andrew for help with English editing.
We thank Dr. Yuming Xu for being advisers in study design, and interpretation; Dr. Kai Liuand Dr. Bo Song for drafting the article; Dr. Yunchao Wang, Dr. Lulu Pei, Dr. Kaihao Han and Dr. Shen Li for data collection; Dr. Yuan Gao, Dr. Lu Zhao and Dr. Hui Fang for data analysis; Dr. Yusheng Li for revising the article.
Source of Support
The work was supported by the Grants from the Science and Technology Department of the Henan Province (No. 152102310058 to Dr. Bo Song), the National Natural Science Foundation of China Grants (Nos. 81530037 and 81471158 to Dr. Yuming Xu; No. 81571158 to Dr. Bo Song) and China Scholarship Council (to Dr. Kai Liu).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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