Evidence map›Paper›PMID 31209179›Full record

ArticleNeurology2019

Low hemoglobin and hematoma expansion after intracerebral hemorrhage.

David J Roh, David J Albers, Jessica Magid-Bernstein, Kevin Doyle, Eldad Hod, Andrew Eisenberger, Santosh Murthy, Jens Witsch, Soojin Park, Sachin Agarwal and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed.

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  15. Development of a machine learning model for prediction of intraventricular hemorrhage in premature neonates.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024
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  16. Article
  17. Article
  18. Perioperative care in infective endocarditis.Indian journal of thoracic and cardiovascular surgery · 2024
    Review
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  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

David J RohFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT. dr2753@cumc.columbia.edu.
David J AlbersFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.ORCID 0000-0002-5369-526X
Jessica Magid-BernsteinFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.ORCID 0000-0001-6506-6017
Kevin DoyleFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Eldad HodFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Andrew EisenbergerFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Santosh MurthyFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Jens WitschFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.ORCID 0000-0001-8924-851X
Soojin ParkFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Sachin AgarwalFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
E Sander ConnollyFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Mitchell S V ElkindFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.
Jan ClaassenFrom Vagelos College of Physicians and Surgeons (D.J.R., D.J.A., J.M.-B., K.D., E.H., A.E., S.P., S.A., E.S.C., M.S.V.E., J.C.), Columbia University; Weill Cornell Medical Center (S.M.), New York, NY; and Yale School of Medicine (J.W.), New Haven, CT.

Funding

Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
NCATS NIH HHS UL1 TR001873
6 · The paper itself

Abstract

objectiveStudies have independently shown associations of lower hemoglobin levels with larger admission intracerebral hemorrhage (ICH) volumes and worse outcomes. We investigated whether lower admission hemoglobin levels are associated with more hematoma expansion (HE) after ICH and whether this mediates lower hemoglobin levels' association with worse outcomes.

methodsConsecutive patients enrolled between 2009 and 2016 to a single-center prospective ICH cohort study with admission hemoglobin and neuroimaging data to calculate HE (>33% or >6 mL) were evaluated. The association of admission hemoglobin levels with HE and poor clinical outcomes using modified Rankin Scale (mRS 4-6) were assessed using separate multivariable logistic regression models. Mediation analysis investigated causal associations among hemoglobin, HE, and outcome.

resultsOf 256 patients with ICH meeting inclusion criteria, 63 (25%) had HE. Lower hemoglobin levels were associated with increased odds of HE (odds ratio [OR] 0.80 per 1.0 g/dL change of hemoglobin; 95% confidence interval [CI] 0.67-0.97) after adjusting for previously identified covariates of HE (admission hematoma volume, antithrombotic medication use, symptom onset to admission CT time) and hemoglobin (age, sex). Lower hemoglobin was also associated with worse 3-month outcomes (OR 0.76 per 1.0 g/dL change of hemoglobin; 95% CI 0.62-0.94) after adjusting for ICH score. Mediation analysis revealed that associations of lower hemoglobin with poor outcomes were mediated by HE (

conclusionsFurther work is required to replicate the associations of lower admission hemoglobin levels with increased odds of HE mediating worse outcomes after ICH. If confirmed, an investigation into whether hemoglobin levels can be a modifiable target of treatment to improve ICH outcomes may be warranted.

Indexed as

AgedAged, 80 and overAnemiaBrainCerebral HemorrhageDisease ProgressionFemaleHematomaHemoglobinsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPrognosisTomography, X-Ray ComputedHemoglobins

Identifiers

PMID31209179
PMCPMC6669932

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