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Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19.
Feng, Shi Nan; Kelly, Thu-Lan; Fraser, John F; Li Bassi, Gianluigi; Suen, Jacky; Zaaqoq, Akram; Griffee, Matthew J; Arora, Rakesh C; White, Nicole; Whitman, Glenn; Robba, Chiara; Battaglini, Denise; Cho, Sung-Min.
Afiliación
  • Feng SN; Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Kelly TL; School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
  • Fraser JF; Critical Care Research Group, Faculty of Medicine, Queensland University of Technology, Brisbane, QLD, Australia.
  • Li Bassi G; Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.
  • Suen J; Critical Care Research Group, Faculty of Medicine, Queensland University of Technology, Brisbane, QLD, Australia.
  • Zaaqoq A; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain.
  • Griffee MJ; Critical Care Research Group, Faculty of Medicine, Queensland University of Technology, Brisbane, QLD, Australia.
  • Arora RC; Department of Critical Care Medicine, MedStar Washington Hospital Center, Georgetown University, Washington, DC.
  • White N; Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT.
  • Whitman G; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH.
  • Robba C; Department of Surgery, Case Western Reserve University, Cleveland, OH.
  • Battaglini D; School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
  • Cho SM; Critical Care Research Group, Faculty of Medicine, Queensland University of Technology, Brisbane, QLD, Australia.
Crit Care Explor ; 6(9): e1143, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-39172625
ABSTRACT

OBJECTIVES:

Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated.

DESIGN:

Retrospective analysis of prospectively collected database.

SETTING:

A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0-11.9 g/dL for women, 10.0-13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS Patients older than 18 years with acute COVID-19 infection in the ICU.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05-1.67).

CONCLUSIONS:

In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Hemoglobinas / Accidente Cerebrovascular / COVID-19 / Paro Cardíaco / Anemia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Crit Care Explor Año: 2024 Tipo del documento: Article País de afiliación: Moldova Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Hemoglobinas / Accidente Cerebrovascular / COVID-19 / Paro Cardíaco / Anemia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Crit Care Explor Año: 2024 Tipo del documento: Article País de afiliación: Moldova Pais de publicación: Estados Unidos