Association between Anemia Severity and Ischemic Stroke Incidence: A Retrospective Cohort Study

Hui-Fen Chen, Tsing-Fen Ho (), Yu-Hung Kuo and Ju-Huei Chien ()
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Hui-Fen Chen: Department of Nephrology, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 88 Fong-Shing Rd., Taichung City 42743, Taiwan
Tsing-Fen Ho: Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, No. 666 Buzih Rd., Taichung City 40601, Taiwan
Yu-Hung Kuo: Department of Research, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 88 Fong-Shing Rd., Taichung City 42743, Taiwan
Ju-Huei Chien: Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, No. 666 Buzih Rd., Taichung City 40601, Taiwan

IJERPH, 2023, vol. 20, issue 5, 1-11

Abstract: Stroke patients presenting with anemia at the time of stroke onset had a higher risk of mortality and development of other cardiovascular diseases and comorbidities. The association between the severity of anemia and the risk of developing a stroke is still uncertain. This retrospective study aimed to evaluate the association between stroke incidence and anemia severity (by WHO criteria). A total of 71,787 patients were included, of whom 16,708 (23.27%) were identified as anemic and 55,079 patients were anemia-free. Female patients (62.98%) were more likely to have anemia than males (37.02%). The likelihood of having a stroke within eight years after anemia diagnosis was calculated using Cox proportional hazard regression. Patients with moderate anemia had a significant increase in stroke risk compared to the non-anemia group in univariate analyses (hazard ratios [HR] = 2.31, 95% confidence interval [CI], 1.97–2.71, p < 0.001) and in adjusted HRs (adj-HR = 1.20, 95% CI, 1.02–1.43, p = 0.032). The data reveal that patients with severe anemia received more anemia treatment, such as blood transfusion and nutritional supplementation, and maintaining blood homeostasis may be important to preventing stroke. Anemia is an important risk factor, but other risk factors, including diabetes and hyperlipidemia, also affect stroke development. There is a heightened awareness of anemia’s severity and the increasing risk of stroke development.

Keywords: anemia; ischemic stroke; elderly; hemoglobin; retrospective cohort study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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