Anemia at admission is associated with poor clinical outcome in cerebral venous thrombosis.

Silvis, Suzanne M; Reinstra, Elza; Hiltunen, Sini; Lindgren, Erik; Heldner, Mirjam R.; Mansour, Maryam; Ghiasian, Masoud; Jood, Katarina; Zuurbier, Susanna M; Groot, Adrien E; Arnold, Marcel; Barboza, Miguel A; Arauz, Antonio; Putaala, Jukka; Tatlisumak, Turgut; Coutinho, Jonathan M (2020). Anemia at admission is associated with poor clinical outcome in cerebral venous thrombosis. European journal of neurology, 27(4), pp. 716-722. Wiley 10.1111/ene.14148

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BACKGROUND

Anemia is associated with poor clinical outcome after ischemic and hemorrhagic stroke. We examined the association between anemia and outcome in patients with cerebral venous thrombosis (CVT).

METHODS

Consecutive adult patients with CVT were included from seven centers. Anemia at admission was scored according to World Health Organization definitions. Poor clinical outcome was defined as a modified Rankin Scale (mRS) 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, we adjusted for age, sex, cancer, and center of recruitment (model 1). In a secondary analysis we additionally adjusted for coma, intracerebral hemorrhage, non-hemorrhagic lesion, and deep venous system thrombosis (model 2). In a sensitivity analysis we excluded patients with cancer.

RESULTS

Data of 952 patients with CVT were included, 22% of whom had anemia at admission. Patients with anemia more often had a history of cancer (17% vs. 7%, p<0.001) than patients without anemia. Poor clinical outcome (21% vs. 11%, p<0.001) and mortality (11% vs. 6%, p=0.07) were more common among patients with anemia. After adjustment, anemia 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 anemia at admission.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Heldner, Mirjam Rachel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1468-1331

Publisher:

Wiley

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

16 Jan 2020 09:53

Last Modified:

28 Dec 2020 02:30

Publisher DOI:

10.1111/ene.14148

PubMed ID:

31883169

Uncontrolled Keywords:

anemia cerebral venous thrombosis prognosis

BORIS DOI:

10.7892/boris.137730

URI:

https://boris.unibe.ch/id/eprint/137730

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