ArticleRelationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study12
Section snippets
Patient sample
A total of 1012 patients with ischemic stroke (International Classification of Diseases, 9th Revision, Clinical Modifications [ICD-9-CM] codes 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91, 436) admitted to the University of Virginia Health System between August 3, 1995, and June 24, 1999, were included in this study. Data on these patients were obtained from the Clinical Data Repository, a health system-wide database consisting of patient-level data assimilated from
Results
Our patient sample had a mean age of 68 years. Men represented 51% of the sample and women 49%. All but 7 of the patients were white (72%) or African American (28%). Frequent comorbid diagnoses included hypertension (65%) and diabetes (33%). More than 95% of patients had a hematocrit level recorded on their first day in the hospital. Twenty-three percent of patients had hematocrit levels that exceeded 45%; 2% had hematocrit levels below 30%. Median hematocrit level was 41.1%, with 25th and 75th
Discussion
Hematocrit level is the main determinant of both blood oxygen carrying capacity and blood viscosity.25 Early studies have shown that oxygen transport is reduced at low hematocrit levels because of low blood oxygen content.26 However, oxygen transport is also reduced at high hematocrit levels because of increased blood viscosity and slowed blood flow. Oxygen transport appears optimal at hematocrit levels of approximately 40%.26 These findings from earlier studies lend theoretical support to the
Conclusion
Midrange hematocrit levels were associated with discharge to home, whereas higher and lower hematocrit levels were associated with discharge to an inpatient rehabilitation unit or an SNF; no association was identified between hematocrit levels and hospital LOS, hospital charges, or mortality. Our preliminary findings suggest that hematocrit level at the time of ischemic stroke may have clinical relevance for outcome. Additional study is necessary to delineate more clearly the association
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Published as an abstract in Archives of Physical Medicine and Rehabilitation 2001;82:1343.
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