W Taylor Kimberly1, Fabricio O Lima, Sydney O'Connor, Karen L Furie. 1. Stroke Service and Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. wtkimberly@partners.org
Abstract
OBJECTIVE: Women have worse outcomes after stroke compared to men. Since women have lower hemoglobin values, we examined whether hemoglobin levels may associate with worse stroke outcomes in women. METHODS: We retrospectively studied 274 patients enrolled in a prospective multicenter study. We explored the relationship of hemoglobin with clinical outcome at 6 months, as measured by the modified Rankin Scale (mRS). Ordinal logistic regression was used to evaluate the independent effect of hemoglobin on clinical outcome, and to explore the influence of sex on that association. RESULTS: Women had a lower mean hemoglobin level (11.7 ± 1.8 g/dL) compared to men (13.3 ± 1.7 g/dL). Low hemoglobin was associated with worse 6-month mRS outcomes in univariate analysis (p < 0.001). Lower hemoglobin remained independently associated with poor outcome after adjustment for comorbid disease, stroke severity, age, and sex. The inclusion of hemoglobin in the model attenuated the independent effect of sex on outcome. CONCLUSIONS: Sex differences in stroke outcome are linked to lower hemoglobin level, which is more prevalent in women. Further examination of this potentially modifiable predictor is warranted.
OBJECTIVE:Women have worse outcomes after stroke compared to men. Since women have lower hemoglobin values, we examined whether hemoglobin levels may associate with worse stroke outcomes in women. METHODS: We retrospectively studied 274 patients enrolled in a prospective multicenter study. We explored the relationship of hemoglobin with clinical outcome at 6 months, as measured by the modified Rankin Scale (mRS). Ordinal logistic regression was used to evaluate the independent effect of hemoglobin on clinical outcome, and to explore the influence of sex on that association. RESULTS:Women had a lower mean hemoglobin level (11.7 ± 1.8 g/dL) compared to men (13.3 ± 1.7 g/dL). Low hemoglobin was associated with worse 6-month mRS outcomes in univariate analysis (p < 0.001). Lower hemoglobin remained independently associated with poor outcome after adjustment for comorbid disease, stroke severity, age, and sex. The inclusion of hemoglobin in the model attenuated the independent effect of sex on outcome. CONCLUSIONS: Sex differences in stroke outcome are linked to lower hemoglobin level, which is more prevalent in women. Further examination of this potentially modifiable predictor is warranted.
Authors: Brian P Walcott; Hooman Kamel; Brandyn Castro; W Taylor Kimberly; Kevin N Sheth Journal: J Stroke Cerebrovasc Dis Date: 2013-10-06 Impact factor: 2.136
Authors: Bhupesh Panwar; Suzanne E Judd; David G Warnock; William M McClellan; John N Booth; Paul Muntner; Orlando M Gutiérrez Journal: Stroke Date: 2016-07-05 Impact factor: 7.914
Authors: Valerian L Altersberger; Lars Kellert; Abdulaziz S Al Sultan; Nicolas Martinez-Majander; Christian Hametner; Ashraf Eskandari; Mirjam R Heldner; Sophie A van den Berg; Andrea Zini; Visnja Padjen; Georg Kägi; Alessandro Pezzini; Alexandros Polymeris; Gian M DeMarchis; Marjaana Tiainen; Silja Räty; Stefania Nannoni; Simon Jung; Thomas P Zonneveld; Stefania Maffei; Leo Bonati; Philippe Lyrer; Gerli Sibolt; Peter A Ringleb; Marcel Arnold; Patrik Michel; Sami Curtze; Paul J Nederkoorn; Stefan T Engelter; Henrik Gensicke Journal: Eur Stroke J Date: 2019-11-13
Authors: C Strewe; D Moser; J-I Buchheim; H-C Gunga; A Stahn; B E Crucian; B Fiedel; H Bauer; P Gössmann-Lang; D Thieme; E Kohlberg; A Choukèr; M Feuerecker Journal: Biol Sex Differ Date: 2019-04-16 Impact factor: 5.027
Authors: Sebastian Bellwald; Rupashani Balasubramaniam; Michael Nagler; Meret S Burri; Samuel D A Fischer; Arsany Hakim; Tomas Dobrocky; Yannan Yu; Fabien Scalzo; Mirjam R Heldner; Roland Wiest; Marie-Luise Mono; Hakan Sarikya; Marwan El-Koussy; Pasquale Mordasini; Urs Fischer; Gerhard Schroth; Jan Gralla; Heinrich P Mattle; Marcel Arnold; David Liebeskind; Simon Jung Journal: PLoS One Date: 2018-09-26 Impact factor: 3.240