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. 2025 Apr 26;17(4):e83031.
doi: 10.7759/cureus.83031. eCollection 2025 Apr.

Association of Anaemia With Higher Mortality and Disability After Subarachnoid Haemorrhage: A Single-Centre Cohort Study

Priyavarshini Ramesh  1   2 , Mark Horner  3 , Marcus Abbawy  4 , Finlay Holden  4 , Suresh Renukappa  4   5 , Subashini Suresh  5 , Cyril Chacko  4 , Randeep Mullhi  3 , Sree Chaitanua Rudrapatma Sathyamurthy  6 , Tonny Veenith  5   4   7
Affiliations

Association of Anaemia With Higher Mortality and Disability After Subarachnoid Haemorrhage: A Single-Centre Cohort Study

Priyavarshini Ramesh et al. Cureus. .

Abstract

Background: Critical care management in subarachnoid haemorrhage (SAH) aims to facilitate neuroprotection and prevent secondary neurological insults. Anaemia after SAH leads to reduced cerebral oxygen delivery and poor outcomes. This study aimed to investigate the association between anaemia and mortality and morbidity outcomes in patients with SAH in tertiary centres, as well as evaluate the impact of blood transfusions on outcomes in anaemic SAH patients. Methods: We performed a retrospective study of 987 patients with SAH at a tertiary neurocritical care centre between September 2016 and September 2018. Data were collected on baseline characteristics, World Federation of Neurosurgical Societies SAH grade, secondary insults such as anaemia and hydrocephalus, and units of blood transfused. The primary outcome was to investigate the correlation between anaemia and 28-day Modified Rankin Scale (MRS) score. Secondary outcomes were delayed neurological deficits, length of stay and death in the intensive care unit (ICU). Anaemia was defined as haemoglobin (Hb) ≤ 95 g/L, and severe anaemia as Hb≤80 g/L. Results: Of the patients, 28.7% had anaemia and 12% had severe anaemia. Anaemia after SAH was associated with an increased risk of death or severe disability (p<0.001), worse survival outcomes (p<0.001) and increased length of stay in ICU (p<0.001).

Conclusions: Anaemia after SAH is associated with a significant increase in mortality and morbidity and should be monitored closely and corrected.

Keywords: acute subarachnoid haemorrhage; anaemia; blood transfusion; intracerebral aneurysms; neurointensive care unit.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CONSORT diagram
CONSORT: Consolidated Standards of Reporting Trails
Figure 2
Figure 2. Comparison of the severity of anaemia and Modified Rankin Score
Figure 3
Figure 3. Haemoglobin levels against Modified Rankin Score
See this image and copyright information in PMC

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