London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 777 817 Rehabilitation and reorganisation after stroke LOW HEMOGLOBIN LEVELS INCREASE UNILATERAL SPATIAL NEGLECT IN STROKE ACUTE PHASE G.J. LUVIZUTTO1, T.A. MONTEIRO2, G.P. BRAGA3, S.G.Z. BAZAN4, L.A.L. RESENDE5, R. BAZAN6 Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL1, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Fil-ho - UNESP, Botucatu, BRAZIL2, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL3, Botucatu Medical School, University Estadual Pau-lista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL4, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL5, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL6 Background: Low haemoglobin (Hb) levels are associated with poor cognitive development after a stroke due to inadequate cerebral oxygen perfusion. The objective of this study was to evaluate the relationship between unilateral spatial neglect (USN) tests and Hb level in individuals in the acute phase stroke. Methods: Observational study of right hemisphere ischemic stroke, confirmed by computerized tomography within 48 hours of ictus, admitted to Botucatu Medical School Uni-versity Hospital, and excluding haemorrhagic stroke, previous modified Rankin Scale (mRS) ≥1, prior Stroke, pre-existing dementia, or other neurological diseases. Independent variable: Hb level (mg/dL); Outcome: USN; Potential confounding factors: Age (years), National Institutes of Health Stroke Scale (NIHSS), mRS after stroke, and glycaemia (mg/dL); Characterization variables were obtained from electronic medical records, Hb and glycaemia by laboratory exams, and USN by Line Cancellation (LCT) and Star Cancelation Tests (SCT). Statistics: A non-probabilistic, intentional sample; The relationship between potential confounding factors and USN by Spearman correlation and Mann-Whitney and the relationship between Hb and USN by Spearman correlation and linear regression model with normal response when normality and homoscedastic suppositions were not violated. Results: Twenty-six individuals were evaluated (66±14.7 years; 65.4% male; NIHSS: 5±2; and mRS at evaluation moment: 3). We observed that the higher the Hb level, the lower the omis-sion of lines and stars in LCT and SCT, where on average around 3 lines IC(β:95%) = (-5.4 - -0.8) and 3 stars IC(β:95%) = (-5.9 - -0.6) are not omitted for each unit increase in Hb (Table 1 and Figure 1). Conclusion: Based on our results, the lower the haemoglobin level, the worse the development in USN tests for acute phase stroke sufferers. Table 1 - Adjusted linear regression models to explain the number of lines omitted in LCT (model 1) and stars omitted in SCT (model 2) in function of haemoglobin. Standard Model 1 β error p IC (β: 95%) Constant 56.2 15.1 0.001 (24.9 - 87.4) Haemoglobin (mg/dL) -3.1 1.1 0.010 (-5.4 - -0.8) Model 2 β Standard error p IC (β: 95%) Constant 71.3 17.3 0.000 (35.6 - 107.0) Haemoglobin (mg/dL) -3.2 1.3 0.018 (-5.9 - -0.6) Residual Analysis and Diagnostics for Model 1: p=0.591 (Shapiro-Wilk); Average indication of heteroscedasticity of residuals; covratio <1 in 1 of 26 observations; R2 = 22.2% Residual Analysis and Diagnostics for Model 2: p=0.829 (Shapiro-Wilk); Weak indication of heteroscedasticity of residuals; covratio <1 in 1 of 26 observations; R2 = 21.9% Figure 1. Number of lines omitted in LCT (2a) and stars omitted in SCT (2b), (y-axis), in function of haemoglobin level (mg/dL) (x-axis).
Karger_ESC London_2013
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