Haemoglobin Levels as a Predictor of Functional Disability and Its Association with Sex Difference in Outcomes of Acute Ischemic Stroke Patients

Author(s): Nitin C. Bharadwaj1 , Dinesha2

BACKGROUND In patients of acute ischemic stroke, there is increased mortality associated with low admission haemoglobin. But limited studies exist on haemoglobin as prognostic predictor of functional outcome in elderly stroke patients. Also, the outcome of stroke is known to be consistently poorer in women than in men. We wanted to correlate this sex difference to haemoglobin variations. METHODS This is a prospective study of 80 patients, diagnosed with acute ischemic stroke conducted from October 2017 to September 2019. Admission haemoglobin levels were noted, and each patient was evaluated for stroke severity with MNIHSS and Charlson Index, a composite measure of comorbidities was computed. At the end of one week, functional outcome was assessed through Barthel index. Multiple Regression analysis was used to determine the relationship of admission haemoglobin to stroke outcomes after adjustment for neurological severity and medical comorbidities. RESULTS Out of 80 cases about 59% were elderly adults; 58.75% were male patients and 41.25% were female patients. 53.75% of these patients belonged to mild functional dependency according to Barthel index and the rest were in moderate to severe dependency. In the study, it was noted that higher the level of haemoglobin better the Barthel Index and hence better the functional outcome, when adjusted for comorbidities. Also, 42.4% of females had severe disability as opposed to 34% of males. However this relationship was not statistically significant. CONCLUSIONS Our study found a significant and positive correlation between admission haemoglobin and the functional outcome of acute ischemic stroke. Elderly patients with higher admission haemoglobin were found to have less severe disability following an acute ischemic stroke. Our study also established a cut off haemoglobin value of 12g/dL and above as being associated with overall favourable outcome in stroke patients. However, the difference in haemoglobin levels between male and female patients could not be correlated as a significant factor contributing to sex differences in stroke outcomes