To investigate the association between hemoglobin(Hb) level at admission and stroke functional outcome in a Tunisian cohort.

Hemoglobin  plays an indirect role in the neurological function and brain recovery. Previous studies have reported that its level was associated with the stroke risk and severity. However its effect on functional outcome has been controversial.

A cross-sectional study was conducted in the Department of Neurology at the university hospital of Sahloul-Sousse-Tunisia from July 2018 and April 2020. Patients, suffering from acute stroke were screened for Hb level at admission. Functional outcome at 3 months were assessed with the modified Rankin Scale (mRs).

A total of 354 stroke patients were included with mean age± SD of 65.8 ±12.8 years and male female rate ratio 1.43. The mean Hb concentration± SD at admission was 13.36± 1.89g/dl. Forty percent of patients had an unfavorable functional outcome (mRs>2). In the univariable analysis, age (p<0.001), gender (p<0.001) , smoking (p=0.01), Obesity (p=0.001) and  Hb level (p=0.02) were associated with functional outcome . However, in the multivariable model, only increasing age (adjusted odds ratio (OR) = 1.07), increasing NIHSS (OR =1.5) and obesity (OR=0.18) remained associated with unfavorable functional outcome.

Our findings suggest that Hb level does not affect stroke functional outcome after adjustment for neurological severity and medical comorbidities.