Evidence map›Paper›PMID 39843877›Full record

ArticleNeurocritical care2025

Hemoglobin Decrements are Associated with Ischemic Brain Lesions and Poor Outcomes in Patients with Intracerebral Hemorrhage.

Fernanda Carvalho Poyraz, Christina P Rossitto, Mohamed Ridha, Marialaura Simonetto, Aditya Kumar, Evan Hess, Emma White, Eric Mao, Laura Sieh, Shivani Ghoshal and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–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

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Fernanda Carvalho PoyrazDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Christina P RossittoDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Mohamed RidhaDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Marialaura SimonettoDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Aditya KumarDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Evan HessDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Emma WhiteDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Eric MaoDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Laura SiehDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Shivani GhoshalDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Sachin AgarwalDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Soojin ParkDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Jan ClaassenDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
E Sander ConnollyDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
J MoccoDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Christopher P KellnerDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
David J RohDepartment of Neurology and Neurosurgery, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA. dr2753@cumc.columbia.edu.ORCID 0000-0003-1927-7686

Funding

New York City Collaborative Regional Coordinating Center (NYCC-RCC)U24NS135391 · NINDS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Christopher Paul Kellner, Aaron Sylvan Lord · 2024 to 2026
$1.3M
Erythrocyte contribution to coagulopathy and cerebral oxygenation after intracerebral hemorrhageK23HL151901 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ROH, DAVID · 2021 to 2025
$950k
NHLBI NIH HHS K23 HL151901NIH HHS K23HL151901NIH HHS U24NS135391
6 · The paper itself

Abstract

backgroundAcute ischemic lesions seen on brain magnetic resonance imaging (MRI) are associated with poor intracerebral hemorrhage (ICH) outcomes, but drivers for these lesions are unknown. Rapid hemoglobin decrements occur in the initial days after ICH and may impair brain oxygen delivery. We investigated whether acute hemoglobin decrements after ICH are associated with MRI ischemic lesions and poor long-term ICH outcomes.

methodsConsecutive patients with acute spontaneous ICH enrolled into a single-center prospective cohort study were assessed. Change in hemoglobin levels from admission to brain MRI was defined as the exposure variable. The presence of MRI ischemic lesions on diffusion-weighted imaging was the primary radiographic outcome. Poor 6-month modified Rankin Scale score (4-6) was assessed as our clinical outcome. Separate regression models assessed relationships between exposure and outcomes adjusting for relevant confounders. These relationships were also assessed in a separate prospective single-center cohort of patients with ICH receiving minimally invasive hematoma evacuation.

resultsOf 190 patients analyzed in our primary cohort, the mean age was 66.7 years, the baseline hemoglobin level was 13.4 g/dL, and 32% had MRI ischemic lesions. Greater hemoglobin decrements were associated with MRI ischemic lesions (adjusted odds ratio [OR] 0.77 for every 1 g/dL change, 95% confidence interval [CI] 0.60-0.99) and with poor 6-month outcomes (adjusted OR 0.73, 95% CI 0.55-0.98) after adjusting for demographics, ICH and medical disease severity, and antithrombotic use. In our separate cohort of 172 surgical patients with ICH, greater hemoglobin concentration decrements similarly associated with MRI ischemic lesions (adjusted OR 0.74, 95% CI 0.56-0.97) and poor 6-month outcomes (adjusted OR 0.69, 95% CI 0.48-0.98).

conclusionsGreater hemoglobin decrements after acute ICH are associated with ischemic lesions on brain MRI and poor long-term outcomes. Further work is required to clarify drivers for these relationships and whether anemia treatment and prevention can be used to improve ICH outcomes.

Indexed as

Brain IschemiaCerebral HemorrhageHemoglobinsOutcome Assessment, Health CareAgedDiffusion Magnetic Resonance ImagingFemaleHumansMaleMiddle AgedProspective StudiesHemoglobinsDiffusion-weighted imagingHemoglobinIntracerebral hemorrhageIschemic brain lesionsMagnetic resonance imagingOutcome

Identifiers

PMID39843877
PMCPMC13052503

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.