Impact of Increased Hemoglobin on Spontaneous Intracerebral Hemorrhage

Yuxuan Lu,Yuhua Zhao,Siwei Chen,Cidan Zhuoga,Jun Xu,Shouzi Zhang,Yuxian Li,Jiayu Tian,Yongan Sun,Feiqi Zhu,Luzeng Chen,Wei Sun,Xiaoting Luan,Haiqiang Jin,Dunzhu Mima,Shunliang Xu

doi:10.1007/s12028-021-01305-1

Abstract

BackgroundStudies of the impact of increased hemoglobin on spontaneous intracerebral hemorrhage (ICH) are limited. The present study aimed to explore the effect of increased hemoglobin on ICH.MethodsA retrospective single-center study using medical records from a database processed by univariate and multivariate analyses was performed in the People’s Hospital of Tibet Autonomous Region in Lhasa, Tibet, China.ResultsThe mean hemoglobin level in 211 patients with ICH was 165.03 ± 34.12 g/l, and a median hematoma volume was 18.5 ml. Eighty-eight (41.7%) patients had large hematomas (supratentorial hematoma ≥ 30 ml; infratentorial hematoma ≥ 10 ml). No differences in ICH risk factors between the groups with different hemoglobin levels were detected. Increased hemoglobin was independently associated with large hematomas [odds ratio (OR) 1.013, P = 0.023]. Increased hemoglobin was independently associated with ICH with subarachnoid hemorrhage (OR 1.014, P = 0.016), which was more pronounced in men (OR 1.027, P = 0.002). Increased hemoglobin was independently associated with basal ganglia hemorrhage and lobar hemorrhage in men (OR 0.986, P = 0.022; OR 1.013, P = 0.044, respectively) but not in women (P > 0.1).ConclusionsIncreased hemoglobin was independently associated with large hemorrhage volume. Increased hemoglobin was independently associated with lobar hemorrhage in men and ICH with subarachnoid hemorrhage, which was more pronounced in men. Additional studies are needed to confirm our findings and explore potential mechanisms.

Highlights

Spontaneous intracerebral hemorrhage (ICH) is a common neurological emergency, contributing the highest number of fatalities among all types of stroke
The basal ganglia was the most common hemorrhagic location reported previously, with a proportion of 34.2– 57.9% [22, 23], and the proportion of basal ganglia hemorrhage in the present study was in agreement with that reported in previous studies
The Role of Hemoglobin in Hematoma Volume and Hemorrhagic Location The results of the present study indicated that increased hemoglobin was associated with hematoma volume and was an independent risk factor for large hematoma

Summary

Introduction

Spontaneous intracerebral hemorrhage (ICH) is a common neurological emergency, contributing the highest number of fatalities among all types of stroke. Overall annual incidence of ICH is 24.6 per 100,000, with a median case fatality of 40.4% at 1 month [1]. Previous studies reported that low hemoglobin levels are Patients living at high altitude, for example, in Tibet, have certain specific clinical characteristics because of long-term exposure to chronic hypoxia and adaptively high hemoglobin levels. We conducted the present study to explore the role of increased hemoglobin in patients with ICH. Studies of the impact of increased hemoglobin on spontaneous intracerebral hemorrhage (ICH) are limited. The present study aimed to explore the effect of increased hemoglobin on ICH

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Results

Discussion

Conclusion