Basic analytical parameters as the predictive factors for 30-day case fatality rate in stroke

Abstract

In a prospective population-based study, analyses were performed to evaluate the 30-day case fatality in stroke as related to the following factors: hematocrit (HCT), hemoglobin (Hgb), red blood cells (RBC), mean cell volume (MCV), platelet count, erythrocyte sedimentation rate (ESR), white blood cells (WBC) and glucose concentration. We studied 345 patients with stroke, 170 men and 175 women, mean age 68.4 +/- 14.2 years, admitted within 72 h of stroke onset. Patients who died had significantly higher mean values of ESR, WBC, HCT and glucose concentration than the patients who survived. Logistic regression analysis revealed that ESR, HCT and WBC are independent factors predicting 30-day case fatality. The odds ratio (OR) for ESR was 1.006 (95% CI 1.0002-1.011), for HCT 1.04 (95% CI 1.01-1.07), for WBC 1.03 (95% CI 1.01-1.05). Glucose concentration after adjusting for the severity of neural deficit did not become an independent predictor.

Impact of Hemoglobin Levels and Anemia on Mortality in Acute Stroke: Analysis of UK Regional Registry Data, Systematic Review, and Meta‐Analysis

“…After detailed screening, 20 studies were included in our systematic review; the flow chart of study selection is shown in Figure 4, and Tables 5 and 6 show the key features of the selected studies. Overall, 10 studies assessed the impact of anemia on stroke1, 2, 10, 16, 17, 18, 19, 20, 21, 22 and 10 evaluated the association between stroke and hemoglobin levels 6, 7, 8, 9, 23, 24, 25, 26, 27, 28. In terms of study design, 3 were retrospective cohort studies,1, 16, 20 13 were prospective cohort studies,2, 6, 7, 8, 9, 10, 17, 18, 19, 22, 23, 24, 25 and 2 were secondary analyses of randomized control trials 27, 28.…”

“…There were also 2 studies that did not state the design 21, 26. There was a high degree of diversity in geographic location, with cohorts from Germany,8, 19, 25 Switzerland,16, 20 the United States,18, 24 the People's Republic of China,2, 22 Canada,23, 28 India,6 Israel,10 the Republic of Korea,9 Denmark,21 Taiwan,17 the United Kingdom,26 and Poland 7. In addition, 2 studies were conducted across multiple countries 1, 27.…”

“…Imaging (computed tomography, magnetic resonance imaging, or both) was used in 17 studies,1, 2, 6, 7, 8, 10, 17, 18, 19, 20, 21, 22, 23, 24, 25, 27, 28 1 study relied on clinical evaluation alone,26 and 2 did not state the method used 9, 16. The methods used to ascertain mortality also varied.…”

“…Telephone interviews were used by 7 studies, typically in conjunction with other methods such as outpatient visit, home visit, mailed questionnaire, analysis of death registries, or review of medical records 6, 8, 9, 16, 18, 19, 22. One study used outpatient visits only,17 and the method used to establish mortality status was unclear in 6 studies 1, 2, 7, 26, 27, 28. Despite the variety of approaches taken to ascertain mortality, all seemed reliable.…”

“…Eleven studies used the World Health Organization definition of anemia as hemoglobin cutoffs,2, 8, 10, 16, 17, 18, 19, 20, 21, 22, 24 7 used prespecified values,1, 9, 23, 25, 26, 27, 28 and 2 did not specify the values used 6, 7. By using prespecified thresholds in constructing categorical comparisons for anemia, it is possible that cut points have been drawn up that favor statistically significant findings.…”