| Factors associated with the development of anemia after subarachnoid hemorrhage. | |
| | |
MedLine Citation:
|
PMID: 19777386 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Anemia is common after subarachnoid hemorrhage (SAH) and may exacerbate the reduction in oxygen delivery that underlies delayed cerebral ischemia. Fall in hemoglobin may relate to blood loss as well as inflammatory suppression of erythropoiesis. Identifying factors associated with anemia may facilitate targeted interventions, such as the use of erythropoiesis-stimulating agents, which could minimize the burden of anemia and reduce red blood cell (RBC) transfusion requirements. METHODS: We analyzed a cohort of patients with spontaneous SAH admitted over a 3-year period who survived at least 4 days. All patients had daily hematocrit values drawn while in the ICU. Multivariate regression was performed to determine baseline and early post-admission variables associated with development of anemia (defined as hematocrit < 30%). RESULTS: Anemia developed in 47% of 243 patients with SAH after a mean of 3.5 days (median 2 days). Admission variables independently associated with anemia were female gender (OR 3.7, 95% CI 1.8-7.6), baseline hematocrit < 36% (OR 3.9, 1.5-10.1 compared to 36-45%), history of hypertension (OR 2.1, 1.05-4.2), and poor clinical grade (OR 5.9, 2.3-15.0). Surgical aneurysm treatment (OR 13.5, 6.0-30.3) and greater admission SIRS score (OR 5.7, 1.7-19.2 if 3-4 criteria for systemic inflammatory response syndrome were met on day of admission compared to none) were also associated with fall in hematocrit. CONCLUSIONS: It may be possible to predict those most likely to develop anemia using simple baseline clinical variables. Anemia was strongly related to surgery, likely through greater blood loss, and greater systemic inflammatory response on admission, possibly explained by cytokine-mediated inhibition of RBC production. |
| | |
Authors:
|
Tomoko R Sampson; Rajat Dhar; Michael N Diringer |
Related Documents
:
|
2048396 - Cerebral blood flow and metabolism following subarachnoid haemorrhage: effect of subara... 1456096 - A primate model for acute and late cerebral vasospasm: angiographic findings. 8875596 - Nimodipine does not increase cerebral blood flow during subarachnoid hemorrhage in the ... 1900646 - Cerebrovascular co2 reactivity during delayed vasospasm in a canine model of subarachno... 2973816 - Trial of the rbc aggregometer head for estimating blood flow in veins in vivo. 21261556 - Matrix metalloproteinase-19 expressed in cerebral amyloid angiopathy. |
Publication Detail:
|
Type: Journal Article Date: 2009-09-24 |
Journal Detail:
|
Title: Neurocritical care Volume: 12 ISSN: 1556-0961 ISO Abbreviation: Neurocrit Care Publication Date: 2010 Feb |
Date Detail:
|
Created Date: 2010-02-05 Completed Date: 2010-05-18 Revised Date: 2010-09-28 |
Medline Journal Info:
|
Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
|
Languages: eng Pagination: 4-9 Citation Subset: IM |
Affiliation:
|
Department of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8111, Saint Louis, MO 63110, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Anemia / mortality, physiopathology*, therapy Aneurysm, Ruptured / mortality, physiopathology*, therapy Brain Ischemia / mortality, physiopathology, therapy Combined Modality Therapy Erythrocyte Transfusion Erythropoiesis / physiology Female Hematinics / therapeutic use Hemoglobinometry* Humans Intensive Care Units Intracranial Aneurysm / mortality, physiopathology*, therapy Male Middle Aged Oxygen / blood* Prospective Studies Risk Factors Subarachnoid Hemorrhage / mortality, physiopathology*, therapy Vasospasm, Intracranial / mortality, physiopathology, therapy |
| Grant Support | |
ID/Acronym/Agency:
|
P01 NS035966-09/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Hematinics; 7782-44-7/Oxygen |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Efficiency and Safety of a Standardized Protocol for Intravenous Insulin Therapy in ICU Patients wit...
Next Document: Revascularization of Onyx Induced Intra-Operative Occlusion of Vertebro-Basilar Artery Using the Mer...