Anemia and outcome of patients with ischemic stroke in a referral hospital in Cameroon

Abstract

Stroke and anemia are major public health concerns in Sub-Saharan Africa. However, few data are available on anemia and acute ischemic stroke in our setting. To assess the impact of anemia on the outcome of patients with ischemic stroke. We collected retrospectively data of patients >15 years hospitalized for ischemic stroke at the Douala General Hospital over a period of 9 years, in whom full blood count was done. Anemia was classified as mild, moderate and severe. Multivariate analysis was used to determine predictive factors of poor outcome at 3 months (mortality and poor functional recovery) in ischemic stroke patients with anemia. A total of 691 patients (male, 53.3 %) male were included. Anemia was found in 44.4 % of cases (severe anemia, 10.4 %). Severe anemia was significantly associated with poor functional recovery at 3 months (OR:4.43, 95 %CI:1.02–12.24, p = 0.04). We found no difference in mortality at 3 months between patients with (4.6 %, n = 14) and without (3.9 %, n = 15) anemia (OR:1.48, 95 %CI:0.69–3.14, p = 0.330). Age > 60 years, diastolic blood pressure > 90 mmHg, NIHSS score ≥ 15, and INR > 1.2 were predictive factors of mortality at 3 months in ischemic stroke patients with anemia. Anemia is common in ischemic stroke cases and must be systematically screened. • More than two out of five patients with ischemic stroke have anemia. • Anemia was found as predictive factor of ischemic stroke mortality at 3 months. • Patients with severe anemia were more likely to have poor functional recovery after a follow up of 3 months.