Anaemia at admission is associated with poor clinical outcome in cerebral venous thrombosis.
anaemia
cerebral venous thrombosis
prognosis
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
29
07
2019
accepted:
22
11
2019
pubmed:
29
12
2019
medline:
3
3
2021
entrez:
29
12
2019
Statut:
ppublish
Résumé
Anaemia is associated with poor clinical outcome after ischaemic and haemorrhagic stroke. The association between anaemia and outcome in patients with cerebral venous thrombosis (CVT) was examined. Consecutive adult patients with CVT were included from seven centres. Anaemia at admission was scored according to World Health Organization definitions. Poor clinical outcome was defined as a modified Rankin Scale score 3-6 at last follow-up. A multiple imputation procedure was applied for handling missing data in the multivariable analysis. Using binary logistic regression analysis, adjustments were made for age, sex, cancer and centre of recruitment (model 1). In a secondary analysis, adjustments were additionally made for coma, intracerebral haemorrhage, non-haemorrhagic lesion and deep venous system thrombosis (model 2). In a sensitivity analysis, patients with cancer were excluded. Data for 952 patients with CVT were included, 22% of whom had anaemia at admission. Patients with anaemia more often had a history of cancer (17% vs. 7%, P < 0.001) than patients without anaemia. Poor clinical outcome (21% vs. 11%, P < 0.001) and mortality (11% vs. 6%, P = 0.07) were more common amongst patients with anaemia. After adjustment, anaemia at admission increased the risk of poor outcome [adjusted odds ratio (aOR) 2.4, 95% confidence interval (CI) 1.5-3.7, model 1]. Model 2 revealed comparable results (aOR 1.9, 95% CI 1.2-3.2), as did the sensitivity analysis excluding patients with cancer (aOR 2.3, 95% CI 1.3-3.8, model 1). The risk of poor clinical outcome is doubled in CVT patients presenting with anaemia at admission.
Sections du résumé
BACKGROUND AND PURPOSE
Anaemia is associated with poor clinical outcome after ischaemic and haemorrhagic stroke. The association between anaemia and outcome in patients with cerebral venous thrombosis (CVT) was examined.
METHODS
Consecutive adult patients with CVT were included from seven centres. Anaemia at admission was scored according to World Health Organization definitions. Poor clinical outcome was defined as a modified Rankin Scale score 3-6 at last follow-up. A multiple imputation procedure was applied for handling missing data in the multivariable analysis. Using binary logistic regression analysis, adjustments were made for age, sex, cancer and centre of recruitment (model 1). In a secondary analysis, adjustments were additionally made for coma, intracerebral haemorrhage, non-haemorrhagic lesion and deep venous system thrombosis (model 2). In a sensitivity analysis, patients with cancer were excluded.
RESULTS
Data for 952 patients with CVT were included, 22% of whom had anaemia at admission. Patients with anaemia more often had a history of cancer (17% vs. 7%, P < 0.001) than patients without anaemia. Poor clinical outcome (21% vs. 11%, P < 0.001) and mortality (11% vs. 6%, P = 0.07) were more common amongst patients with anaemia. After adjustment, anaemia at admission increased the risk of poor outcome [adjusted odds ratio (aOR) 2.4, 95% confidence interval (CI) 1.5-3.7, model 1]. Model 2 revealed comparable results (aOR 1.9, 95% CI 1.2-3.2), as did the sensitivity analysis excluding patients with cancer (aOR 2.3, 95% CI 1.3-3.8, model 1).
CONCLUSION
The risk of poor clinical outcome is doubled in CVT patients presenting with anaemia at admission.
Identifiants
pubmed: 31883169
doi: 10.1111/ene.14148
pmc: PMC7155011
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
716-722Informations de copyright
© 2019 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
Références
Stroke. 2015 Oct;46(10):2735-40
pubmed: 26272383
J Thromb Haemost. 2012 Sep;10(9):1768-74
pubmed: 22784217
Stroke. 2004 Mar;35(3):664-70
pubmed: 14976332
Acta Neurol Scand. 2017 Jun;135(6):596-602
pubmed: 27480069
Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1):R403-14
pubmed: 16973934
Stroke. 2005 Mar;36(3):660-4
pubmed: 15692112
Cochrane Database Syst Rev. 2016 Oct 12;10:CD002042
pubmed: 27731885
Am J Med. 2017 Feb;130(2):198-206
pubmed: 27742261
J Am Heart Assoc. 2016 Aug 17;5(8):
pubmed: 27534421
Nat Rev Neurol. 2017 Sep;13(9):555-565
pubmed: 28820187
Neurocrit Care. 2018 Dec;29(3):463-468
pubmed: 29987689
Neurosurgery. 2011 May;68(5):1286-92
pubmed: 21307801
Stroke. 2011 Apr;42(4):1158-92
pubmed: 21293023
PLoS One. 2018 Sep 26;13(9):e0203535
pubmed: 30256814
Cell Calcium. 2004 Sep-Oct;36(3-4):265-75
pubmed: 15261482
Stroke. 2014 May;45(5):1338-41
pubmed: 24699058
Thorax. 2012 Apr;67(4):328-33
pubmed: 22169361