Anemia as a Predictor of Mortality in Indian Patients With Cerebral Venous Thrombosis: A Six-Month Follow-Up Study

Abstract

Objectives

Anemia has been associated with cerebral venous thrombosis (CVT) and poor outcomes. There have been no Indian studies in this regard. We studied the frequency and type of anemia, and CVT outcomes at 6 months.

Methods

In this ambispective, observational study imaging confirmed CVT patients were enrolled. Anemia was defined by WHO criteria: in men hemoglobin <13 g/dL, non-pregnant women hemoglobin <12 g/dL and pregnant women hemoglobin <11 g/dL. Mortality and poor outcome ie, modified Rankin scale (mRS) score of 3-6 at 6-month were the outcomes. Association between admission anemia and outcome was examined using binary logistic regression after adjusting for potential confounders-namely, age, sex, poor GCS, alcohol, smoking, and involvement of multiple sinuses.

Results

Data of 203 CVT patients (94 retrospective and 109 prospective) were analysed. Anemia was present in 96/203 (47%) patients, microcytic anemia being most frequent type (47/96, 49%) based on erythrocyte morphology. Severe anemia comprised 24% (23/96) of the patients with anemia. As per iron studies, 61/96 (64%) anemia patients had iron-deficiency anemia. At 6-month poor outcome was present in 38% vs 23% (P = 0.02), mortality was 34% vs 20% (P = 0.03) in anemic and non-anemic group respectively. After adjustment for confounders anemia was independently associated with increased risk of poor outcome (aOR 4.3; 95% CI 1.3-13.9) and mortality (aOR 5.2; 95% CI 1.4-19.3).

Conclusion

At admission, anemia is present in almost half CVT patients and is associated with increased risk of poor outcome and higher mortality.