Correlation between hematocrit and early neurological deterioration in patients with acute ischemic stroke on admission

Objective To investigate the value of early hematocrit (Hct) level in predicting early neurological deterioration (END) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke within 24 h of onset were enrolled prospectively. They were divided into low Hct, normal Hct, and high Hct according to the quantile of the measured Hct. END was defined as an increase of ≥2 of the National Institute of Health Stroke Scale (NIHSS) score or ≥1 of the motor item score within 5 d after admission compared with the baseline. The vascular risk factors, clinical features, baseline NIHSS score, infarct size, and laboratory test variables were compared between the END group and the non-END group. Multivariate logistic regression analysis was used to identify the independent risk factors for END. Results A total of 216 patients with acute ischemic stroke were enrolled, including 128 males (59.26%). Their mean age was 67.40±14.12 years. Sixty-two patients (28.70%) experienced END. The normal ranges of Hct in male and female were 40.12%-46.35% and 38.32%-44.17%, respectively. Univariate analysis indicated that there were significantly differences in baseline NIHSS score (P=0.001), fasting glucose (P=0.030), C reactive protein (CRP) (P=0.041), and the proportions of different Hct levels between the END group and the non-END group (P=0.023). The END incidences in patients with high-level Hct (40.0%) and low-level Hct (35.2%) were significantly higher than that in the normal Hct patients (20.4%), but there was no significant difference between the high-level and low-level Hct patients (P=0.690). Multivariate logistic regression analysis showed that the high-level Hct (odds ratio 2.460, 95% confidence interval 1.146-5.283; P=0.021) and the baseline NIHSS score (odds ratio 1.070, 95% confidence interval 1.014-1.129; P=0.013) were the independent risk factors for END. Conclusion The elevated Hct in patients with acute ischemic stroke are susceptible to END. Key words: Stroke; Brain Ischemia; Disease Progression; Hematocrit; Risk Factors; Time Factors