Abstract Number: Esoc2026a2260 Analyzing the Effects of Anemia on the Outcomes of Mechanical Thrombectomy in Ischemic Stroke Patients: A Systematic Review and Meta-Analysis

Abstract Background and aims Anemia is a common yet often overlooked condition in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy. Hemoglobin levels play a crucial role in oxygen transport, and their depletion may exacerbate ischemic injury and worsen functional outcomes. While anemia has been associated with poor stroke prognosis, conflicting evidence exists regarding its impact on post-thrombectomy outcomes. This meta-analysis aimed to evaluate the effect of anemia on the functional and survival outcomes of patients with AIS treated with mechanical thrombectomy. Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched electronic databases (PubMed, Scopus, and Web of Science) to identify eligible studies reported up to January 2025. Using Review Manager software, we reported outcomes as odds ratios (ORs) or mean difference (MD) and confidence intervals (CIs). A p-value ≤ 0.05 was considered statistically significant. Results Nine retrospective cohort studies comprising 2,189 patients were included. Anemia was significantly associated with lower odds of achieving good functional outcomes (OR = 0.30, 95% CI: 0.13-0.68, p=0.004) and a higher risk of mortality (OR = 1.76, 95% CI: 1.19-2.60, p=0.005). No significant association was found between anemia and symptomatic intracerebral hemorrhage risk (OR = 0.95, 95% CI: 0.34-2.27, p=0.91). Younger age, lower baseline NIH Stroke Scale, and higher hemoglobin levels were significant predictors of good prognosis. Conclusions Anemia negatively impacted functional recovery and survival in patients with AIS undergoing mechanical thrombectomy. Given these findings, optimizing hemoglobin levels may be a potential strategy to improve patient outcomes. Conflict of interest Nothing to declare Table 1 - belongs to Methods Table 2 - belongs to Results Table 3 - belongs to Conclusions