Abstract:
Anaemia is a multicausal clinical condition affecting nearly one in two patients with aneurysmal subarachnoid haemorrhage (aSAH). Cerebral oxygen delivery depends on blood flow and Hb concentration. In acute brain injury, including aSAH, compensatory mechanisms are impaired, making anaemic patients more susceptible to cerebral hypoxia. Although the impact of elevated Hb levels in aSAH remains insufficiently studied, both low and high Hb levels are believed to influence cerebral perfusion, particularly under conditions of cerebral vasospasm.Objective — to determine the impact of baseline Hb level on the prediction of the clinical course and outcome in patients with ruptured cerebral aneurysms. Materials and methods. A retrospective single-centre cross-sectional study was conducted. It involved the analysis of 492 medical records of patients in the acute phase of cerebral aneurysms (CA) rupture. Patients were divided into three groups according to Hb levels. The analysis included demographic and clinical data, Hb levels, anatomical and morphological features of CA, treatment method, complications, and outcomes. Results and discussion. Patients with elevated Hb levels were significantly older (p = 0.013). Female sex was significantly associated with both low and high Hb levels, with women being nearly twice as likel to belong to the low Hb group (p = 0.013) and 5.6 times more likely to belong to the high Hb group (p < 0.001). Patients with high Hb levels had significantly reduced odds of developing pneumonia (p = 0.026). Elevated Hb levels were associated with a 2.4-fold increase in the likelihood of being discharged with the Hospital Assessment Scale 2 (p = 0.039). Conclusions. These findings suggest that both decreased and elevated Hb levels are differentially associated with age, sex, incidence of pneumonia, and treatment outcomes in patients with ruptured CA.
