The association between hemoglobin concentration and clinical outcomes after aneurysmal subarachnoid hemorrhage: Insights from the LongTEAM registry

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2023-10-17 DOI:10.1111/cns.14506

Fa Lin, Changyu Lu, Runting Li, Yu Chen, Heze Han, Yuanli Zhao, Xiaolin Chen, Jizong Zhao

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引用次数: 0

Abstract

Objective

The aim of this study is to explore whether preoperative hemoglobin levels could serve as a prospective biomarker for early brain injury in patients with aneurysmal subarachnoid hemorrhage (aSAH). This investigation seeks to discern its association with postoperative complications and unfavorable clinical outcomes.

Methods

We conducted a comprehensive analysis of data derived from the LongTeam registry, including patients with aSAH diagnosed between January 2015 and September 2021. These patients were stratified into three distinct groups based on their hemoglobin levels: anemic, standard, and elevated HGB. We employed logistic models featuring spline transformations to assess the relationship between HGB levels and in-hospital complications. Furthermore, a multivariate Cox proportional hazard model was employed to estimate the impact of elevated hemoglobin levels on the hazard function, which was elucidated through Kaplan–Meier curves.

Results

Our study comprised a total of 988 patients, among whom 115 (11.6%) presented preoperative anemia, and 63 (6.4%) exhibited elevated preoperative HGB levels. Following adjustments for potential confounding factors, no significant disparity in risk was evident between anemic patients and those with standard HGB levels. However, individuals with elevated HGB levels displayed a heightened incidence and an increased risk of developing deep vein thrombosis (DVT, odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.16–4.91, p = 0.018; hazard ratio [HR] = 2.05, 95% CI 1.08–3.92, p = 0.015). Aberrant HGB concentrations did not demonstrate an association with other clinical outcomes.

Conclusion

Our findings emphasize that abnormal HGB levels show no association with adverse outcomes at the 90 days mark after accounting for clinical confounding factors in patients with aSAH. Simultaneously, the study illuminates the potential of HGB as an early indicator for identifying patients at a heightened risk of developing DVT.

Abstract Image

查看原文本刊更多论文

动脉瘤性蛛网膜下腔出血后血红蛋白浓度与临床结果之间的关系：来自LongTEAM注册表的见解。

目的：本研究的目的是探讨动脉瘤性蛛网膜下腔出血（aSAH）患者术前血红蛋白水平是否可以作为早期脑损伤的前瞻性生物标志物。本研究旨在了解其与术后并发症和不良临床结果的关系。方法：我们对LongTeam注册中心的数据进行了全面分析，包括2015年1月至2021年9月期间诊断为aSAH的患者。这些患者根据血红蛋白水平分为三组：贫血组、标准组和HGB升高组。我们采用了具有样条变换的逻辑模型来评估HGB水平与住院并发症之间的关系。此外，采用多变量Cox比例风险模型来估计血红蛋白水平升高对风险函数的影响，通过Kaplan-Meier曲线对此进行了阐述。结果：我们的研究共包括988名患者，其中115名（11.6%）患者出现术前贫血，63名（6.4%）患者术前HGB水平升高。在对潜在的混杂因素进行调整后，贫血患者和标准HGB水平的患者之间的风险没有明显差异。然而，HGB水平升高的个体表现出发病率升高和发展为深静脉血栓形成的风险增加（DVT，比值比[OR] = 2.39，95%置信区间[CI] = 1.16-4.91，p = 0.018；危险比 = 2.05，95%置信区间1.08-3.92，p = 0.015）。异常的HGB浓度没有显示出与其他临床结果的相关性。结论：我们的研究结果强调，HGB水平异常与90岁时的不良结果无关在考虑了aSAH患者的临床混杂因素后的第天。同时，该研究阐明了HGB作为早期指标的潜力，以确定DVT风险较高的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.