ArticlePloS one2018
Association of anemia and hemoglobin decrease during acute stroke treatment with infarct growth and clinical outcome.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 31 citations in OpenAlex.
- Aortic occlusion requiring surgery in a patient with autoimmune hemolytic anemia and severe anemia: a case report.International journal of surgery case reports · 2026Article
- Peri-procedural decrease in hemoglobin following mechanical thrombectomy for ischemic stroke.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Beyond Hemoglobin Levels: Integrating Anemia Phenotyping Into Prognostic Models for Patients With Stroke Following Intravenous Thrombolysis.Journal of the American Heart Association · 2026Article
- Analyzing the effects of anemia on the outcomes of mechanical thrombectomy in ischemic stroke patients: a systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2026Article
- Anemia and outcome of patients with ischemic stroke in a referral hospital in Cameroon.eNeurologicalSci · 2025Article
- Evaluation of Hemoglobin and Eosinophil Count in Patients Receiving Thrombolytic Treatment.Cureus · 2024Article
- Exploring Relationships of Heart Rate Variability, Neurological Function, and Clinical Factors with Mortality and Behavioral Functional Outcome in Patients with Ischemic Stroke.Diagnostics (Basel, Switzerland) · 2024Article
- Association Between Anemia and Clinical Outcome in Acute Ischemic Stroke Patients Treated With Endovascular Treatment.Journal of stroke · 2024Article
- Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke.Frontiers in neurology · 2023Article
- Optimizing acute stroke outcome prediction models: Comparison of generalized regression neural networks and logistic regressions.PloS one · 2022Article
- Anemia and risk of periprocedural cerebral injury detected by diffusion-weighted magnetic resonance imaging in patients undergoing transcatheter aortic valve replacement.World journal of emergency medicine · 2022Article
- Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack.Journal of the American Heart Association · 2021Article
- Evaluating Outcome Prediction Models in Endovascular Stroke Treatment Using Baseline, Treatment, and Posttreatment Variables.Stroke (Hoboken, N.J.) · 2021Article
- Cerebrovascular Complications of Anemia.Current neurology and neuroscience reports · 2021Review
- Blood Pressure Management in Acute Ischemic Stroke.Current hypertension reports · 2020Review
- Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients.European stroke journal · 2020Article
- Timing of Transfusion, not Hemoglobin Variability, is Associated with 3-Month Outcomes in Acute Ischemic Stroke.Journal of clinical medicine · 2020Article
- Anaemia at admission is associated with poor clinical outcome in cerebral venous thrombosis.European journal of neurology · 2020Article
- Estimated glomerular filtration rate, anemia and outcomes in patients with ischemic stroke.Annals of translational medicine · 2020Article
Corrections and comments
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Authors and funding
22 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAnemia is associated with worse outcome in stroke, but the impact of anemia with intravenous thrombolysis or endovascular therapy has hardly been delineated. The aim of this study was to analyze the role of anemia on infarct evolution and outcome after acute stroke treatment.
methods1158 patients from Bern and 321 from Los Angeles were included. Baseline data and 3 months outcome assessed with the modified Rankin Scale were recorded prospectively. Baseline DWI lesion volumes were measured in 345 patients and both baseline and final infarct volumes in 180 patients using CT or MRI. Multivariable and linear regression analysis were used to determine predictors of outcome and infarct growth.
results712 patients underwent endovascular treatment and 446 intravenous thrombolysis. Lower hemoglobin at baseline, at 24h, and nadir until day 5 predicted poor outcome (OR 1.150-1.279) and higher mortality (OR 1.131-1.237) independently of treatment. Decrease of hemoglobin after hospital arrival, mainly induced by hemodilution, predicted poor outcome and had a linear association with final infarct volumes and the amount and velocity of infarct growth. Infarcts of patients with newly observed anemia were twice as large as infarcts with normal hemoglobin levels.
conclusionAnemia at hospital admission and any hemoglobin decrease during acute stroke treatment affect outcome negatively, probably by enlarging and accelerating infarct growth. Our results indicate that hemodilution has an adverse effect on penumbral evolution. Whether hemoglobin decrease in acute stroke could be avoided and whether this would improve outcome would need to be studied prospectively.
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