ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1616847
This article is part of the Research TopicThe burden and impact of frailty in strokeView all 4 articles
Correlation between the hemoglobin-to-hematocrit ratio and 3-month outcomes in patients with acute ischemic stroke: a secondary analysis based on a prospective cohort study
Provisionally accepted
- 1Hunan University of Chinese Medicine, Changsha, China
- 2Changde Hospital, Xiangya School of Medicine, Central South University, Changde, Changde, China
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Abstract: Background: Our study dedicated to clarify the connection between the hemoglobin (HB) to hematocrit (HCT) (HB/HCT) ratio and adverse outcomes (AOs) in patients with acute ischemic stroke (AIS) within 3 months. Methods: A total of 1906 individuals with AIS were encompassed at a hospital in South Korea. A binary logistic regression model (BLRM) was utilized to explore the linear relationship between the HB/HCT ratio and AOs in patients with AIS. Additionally, generalized additive models (GAMs) and smooth curve fitting were leveraged to investigate the nonlinear relationship between the HB/HCT ratio and AOs in patients with AIS. Two steps recursive method was adopted to calculate the inflection point. Results: There was a nonlinear relationship between the HB/HCT ratio (per 0.01) and AOs in AIS patients according to the GAMS score and smooth curve fitting. The inflection point of the HB/HCT ratio (per 0.01) is 33.191. On the left side of the inflection point, the risk of AOs decreased by 27.80% for every 1 unit increase in the HB/HCT ratio (per 0.01) (odds ratio (OR) = 0.722, 95% confidence interval (CI): 0.577, 0.903, p = 0.004). On the right side of the inflection point, the risk of AOs increased by 20.90% for every 1 unit increase in the HB/HCT ratio (per 0.01) (OR = 1.209, 95% CI: 1.014, 1.440, p = 0.034). Conclusion: Our study revealed a U-shaped relationship between the HB/HCT ratio and the prognosis of AIS. Monitoring HB/HCT ratio may be able to identify patients with AOs in advance, ultimately providing more reference of scientific and effective care for AIS patients which may be linked to the improvement of their clinical outcomes.
Keywords: Hemoglobin 1, Hematocrit 2, stroke 3, Adverse outcomes 4, Cohort study 5
Received: 07 May 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Liu, Liu, Li, Zhou and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongjuan Liu, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, Changde, China
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