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 

作者机构：Neurology ServiceVA Connecticut Healthcare SystemWest HavenConnecticutUSA Department of NeurologyCenter for NeuroEpidemiological and Clinical Neurological ResearchYale University School of MedicineNew HavenConnecticutUSA Department of Internal MedicineYale University School of MedicineNew HavenConnecticutUSA Clinical Epidemiology Research Center(CERC)VA Connecticut Healthcare SystemWest HavenConnecticutUSA Pain ResearchInformaticsMultimorbidities and Education(PRIME)Center of InnovationVA Connecticut Healthcare SystemWest HavenConnecticutUSA Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI)Richard L Roudebush VA Medical CenterIndianapolisIndianaUSA VA Health Services Research and Development(HSR&D)Center for Healthcare InformaticsRichard L Roudebush VA Medical CenterIndianapolisIndianaUSA Division of Chronic Disease EpidemiologyYale School of Public HealthWest HavenConnecticutUSA Medical ServiceVA Connecticut Healthcare SystemWest HavenConnecticutUSA Regenstrief InstituteIndianapolisIndianaUSA Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA Department of Internal MedicineIndiana University School of MedicineIndianapolisIndianaUSA 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2018年第3卷第3期

页      面：160-168页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

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 

主　　题：mortality admitted transfusion 

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 *** Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year *** 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 *** factors were calculated to standardise comparisons between haematocrit tier and other *** 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 *** 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 *** differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity *** 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 *** anaemia is associated with 1-year mortality to a greater degree than cancer or heart dise