000K utf8 1100 2022$c2022-12-01 1500 eng 2050 urn:nbn:de:hbz:465-20231026-114317-9 2051 10.1038/s41598-022-24591-x 3000 Said, Maryam 3010 Ahmadipour, Yahya 3010 Chihi, Mehdi 3010 Dammann, Philipp 3010 Darkwah Oppong, Marvin 3010 Dinger, Thiemo Florin 3010 Gümüs, Meltem 3010 Jabbarli, Ramazan 3010 Rauschenbach, Laurèl 3010 Rodemerk, Jan 3010 Schmidt, Börge 3010 Sure, Ulrich 3010 Wrede, Karsten Henning 4000 Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage [Said, Maryam] 4209 Anemia is a common, treatable condition in patients with aneurysmal subarachnoid hemorrhage (SAH) and has been associated with poor outcome. As there are still no guidelines for anemia management after aneurysm rupture, we aimed to identify outcome-relevant severity of anemia in SAH. We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for publications before Oct 23rd, 2022, reporting on anemia in SAH patients. The presence and severity of anemia were assessed according to the reported hemoglobin values and/or institutional thresholds for red blood cells transfusion (RBCT). Out of 1863 original records, 40 full-text articles with a total of 14,701 patients treated between 1996 and 2020 were included in the final analysis (mean 445.48 patients per study). A substantial portion of patients developed anemia during SAH (mean pooled prevalence 40.76%, range 28.3–82.6%). RBCT was administered in a third of the cases (mean 32.07%, range 7.8–88.6%), with institutional threshold varying from 7.00 to 10.00 g/dL (mean 8.5 g/dL). Anemia at the onset of SAH showed no impact on SAH outcome. In contrast, even slight anemia (nadir hemoglobin < 11.0–11.5 g/dL) occurring during SAH was associated with the risk of cerebral infarction and poor outcome at discharge and follow-up. The strongest association with SAH outcome was observed for nadir hemoglobin values ranging between 9.0 and 10.0 g/dL. The effect of anemia on SAH mortality was marginal. The development of anemia during SAH is associated with the risk of cerebral infarction and poor outcome at discharge and follow-up. Outcome-relevant severity of post-SAH anemia begins at hemoglobin levels clearly above the thresholds commonly set for RBCT. Our findings underline the need for further studies to define the optimal management of anemia in SAH patients. 4950 https://doi.org/10.1038/s41598-022-24591-x$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:465-20231026-114317-9$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00078583 5051 610