Contribution of Hematocrit to early mortality after ischemic stroke

Background: Only a few non-recent studies assessed the importance of hematocrit (HCT) in patients with ischemic stroke. We evaluated how HCT might affect early mortality after stroke. Methods: We investigated all first-ever ischemic strokes included in the population-based L'Aquila registry. 3,481 patients according to HCT (%) values were included into four categories ( <= 40, 41 - 45, 46 - 50, and > 50). Results: There were more men than women with HCT 1 50 ( 6.6 vs. 2.8%; p < 0.0001) and more women than men with HCT <= 40 (48.5 vs. 37.9%; p < 0.0001). Proportions of chronic atrial fibrillation ( p = 0.0053) increased in women from the lower to the higher HCT categories. 7- and 28- day case-fatality rates were similar in men and women in the lower HCT categories but higher in women than in men in the higher categories. At the 28- day Kaplan-Meier analysis, men had similar survivals in the different categories while women with HCT 1 50 showed the worst survival (p < 0.0001). At the multivariate Cox regression analysis HCT 46 - 50 and 1 50 was an independent predictor of mortality in women within 28 days. Conclusion: High HCT might represent in women a previously underestimated independent predictor of mortality after ischemic stroke. Consideration of HCT in future stroke trials would be useful for ameliorating stroke care, especially in women. Copyright (c) 2007 S. Karger AG, Basel.