Anemia on admission increases the risk of mortality at 6 months and 1 year in hemorrhagic stroke patients in China.

Background: The relationship between anemia and intracerebral hemorrhage is not clear. We investigated the associations between anemia at the onset and mortality or dependency in patients with intracerebral hemorrhage (ICH) registered at the China National Stroke Registry (CNSR).

Methods: The CNSR recruited consecutive patients with diagnoses of ICH in 2007-2008. Their vascular risk factors, clinical presentations, and outcomes were recorded. The mortality and dependency at 1, 3, and 6 months and at 1 year were compared between ICH patients with and without anemia. A favorable outcome was defined as a modified Rankin Scale (mRS) score of 2 or less and a poor outcome as an mRS score of 3 or more. Multivariable logistic regression was performed to analyze the association between anemia and the 2 outcomes after adjusting for age, gender, body mass index, history of smoking and heavy drinking, National Institutes of Health Stroke Scale score on admission, random glucose value on admission, and hematoma volume.

Results: Anemia was identified in 484 (19%) ICH patients. Compared with ICH patients without anemia, patients with anemia had no difference in mortality rate at discharge and at 1 month. The rate of mortality at 3 months, 6 months, 1 year, and dependency at 1 year were significantly higher for those patients with anemia than those without (P<.05, P<.001, P<.001, and P<.05, respectively). After adjusting for potential confounders, anemia was an independent risk factor for death at 6 months and 1 year (adjusted odds ratio [OR]=1.338, 95% confidence interval 1.01-1.78, and adjusted OR=1.326, 95% confidence interval 1.00-1.75) in ICH patients.

Conclusions: Anemia independently predicted mortality at 6 months and 1 year after the initial episode of intercerebral hemorrhage.