title: Elevated hemoglobin is associated with cerebral infarction in Tibetan patients with primary hemorrhagic neurovascular diseases.
abstract: OBJECTIVE
  Although many studies have focused on primary hemorrhagic neurovascular diseases (PHNVDs) in different races, studies of PHNVDs in the plateau area of China are still insufficient. Chinese Tibetan people are the largest population living in the plateau area. Previous studies have shown that Tibetan PHNVD patients have a significantly higher incidence of cerebral infarction, but the mechanism remains uncertain. This study aimed to develop a better understanding on the mechanism of their high risk of cerebral infarction.
  
  
  METHODS
  In this retrospective case control study, we used a hospital information system to search for consecutive Tibetan patients with PHNVDs from January 2012 to June 2016. Intra-hospital data including baseline information and complications were recorded, and the risk factors for cerebral infarction were analyzed.
  
  
  RESULTS
  Univariate analysis and cox proportional hazard multivariate regression analysis revealed that elevated hemoglobin (HGB) concentration was positively associated with an increased incidence of cerebral infarction (P<0.001). The cutoff value that maximized the ability to predict in-hospital infarction in Tibetans with PHNVDs was 15.2g/dL. Tibetan PHNVD patients with an increased HGB concentration were more likely to present with cerebral infarction within the first 5days after onset of PHNVDs, and the probability was highest on the 3rd day.
  
  
  CONCLUSIONS
  HGB levels could be used to predict in-hospital cerebral infarction in Tibetan patients with PHNVDs. These patients are more likely to develop in-hospital infarction when the HGB concentration is higher than 15.2g/dL. For Tibetan PHNVD patients with an elevated HGB concentration, most cerebral infarctions occurred within the first five days after onset, with more incidents occurring on the third day.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Ruiqi
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Anqi
authors.initials: A
authors.lastname: Xiao
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: huaxi_youchao@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000453:epidemiology*; D002681:China; D005260:Female; D006402:Hematologic Diseases / Q000453:epidemiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*
chemical_list: D006454:Hemoglobins
keywords: Cerebral infarction; Hemoglobin; Primary hemorrhagic neurovascular diseases; Tibetan