Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients

Kaźmierski, Radosław; Guzik, Przemysław; Ambrosius, Wojciech; Ciesielska, Anna; Moskal, Jakub; Kozubski, Wojciech

doi:10.1016/j.clineuro.2004.03.003

Cited by 56 publications

(39 citation statements)

References 23 publications

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“…22 The timing of WBC response in adults was consistent with our findings, which demonstrates the ability of term neonates to mount a neutrophil response that is comparable to adults. Our data also support a previous study by Naeye et al 23 which correlated antenatal bradycardia with lymphocytosis and Paul et al 24 in very low birth weight neonates which showed an association between intraventricular hemorrhage and increased total leukocytes and absolute neutrophils for 72 h after birth.…”

supporting

confidence: 80%

Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates

et al. 2007

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Objective: The present study investigated the relationship between neurologic outcome and total circulating white blood cell (WBC) and absolute neutrophil counts (ANCs) in the first week of life in term infants with hypoxic-ischemic encephalopathy (HIE).Study design: Long-term neurologic outcome at 18 months was measured retrospectively in 30 term neonates with HIE using the Pediatric Cerebral Performance Category Scale (PCPCS) score with outcomes dichotomized as either good or poor. We then compared white blood cell and ANC levels during the first 4 days of life and magnetic resonance imaging (MRI) obtained within the first month life between the two PCPCS groups. MRI was quantified using a validated scoring system. Results:Neonates with good long-term outcomes had significantly lower MRI scores (indicating lesser injury) than neonates with poor outcomes. More importantly, neonates with poor outcomes had significantly higher WBC and ANC levels as early as12 h after birth and up to 96 h after birth compared to those with good outcomes. These data suggest that elevated peripheral neutrophil counts in the first 96 h of life may signal or predict adverse long-term outcome.Conclusions: Our findings suggest that elevated peripheral neutrophil counts in the first 96 h of life in term infants with HIE may contribute to abnormal neurodevelopmental outcome.

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supporting

confidence: 80%

Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates

et al. 2007

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“…eir ndings showed that leukocytosis at admission was related to initial stroke severity but not to outcome; leukocyte count at admission seems merely to re ect initial stroke severity and is most likely a stress response with Peng et al WBC and stroke outcome no independent in uence on outcome. Kazmierski's study [8] showed that an increased WBC count within the rst 12 h of onset of an ischemic stroke was a strong prognostic factor for in-hospital mortality in 400 consecutive acute stroke patients. In the Northern Manhattan Stroke Study [18], 655 patients with rst ischemic stroke were prospectively followed for 5 years for the occurrence of recurrent stroke, myocardial infarction or death.…”

Section: Discussionmentioning

confidence: 99%

“…ere are two studies [16,17] of patients in whom bacterial infections lead to increased WBC counts, which suggest that acute bacterial infections may be associated with ischemic events. ere are, however, con icting reports about the association between WBC count and the prognosis a er onset of cerebral infarction [8][9][10][11]. In 763 unselected patients with stroke, admitted within 24 hours from onset, Kammersgaard et al [9] prospectively studied the relationship between leukocyte count and clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…A study showed that WBC count was predictive of rst ischemic stroke, a er adjustment for vascular risk factors [6]; however, there was no consensus about the relationship between WBC count and the prognosis a er onset of cerebral infarction. Some studies had found that increased WBC count in the rst day of acute ischemic stroke is a prognostic factor of disease progression [7], and the WBC count was an important predictive factor of in-hospital death [8]. ere were also some studies [9][10][11] that did not nd an association between the admission WBC count and clinical outcome.…”

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confidence: 99%

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Relationship between white blood cell count at admission and short term outcome in patients with acute cerebral infarction

Peng

Wang²,

Jiang³

et al. 2011

CIM

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Relationship between white blood cell count at admission and short term outcome in patients with acute cerebral infarction Abstract Purpose: We studied the association between admission white blood cell (WBC) count and short term outcome in patients with acute cerebral infarction.Methods: 2808 patients with acute cerebral infarction were included in the study. WBC count and other variables were collected within the rst 24 hours of admission. Clinical outcomes (death or dependency) were evaluated by neurologists during hospitalization.e associations between WBC count and in-hospital death or dependency at discharge were analyzed using a multiple logistic model.Result: Multivariate-adjusted odds ratio (95% con dence intervals) of dependency associated with patients with WBC of 10.0-10.9×10 9 /L, 11.0-11.9×10 9 /L, ≥12.0×10 9 /L were 1.46(0. 87-2. 45), 6.21(3. 70-10. 42) and 7.01(4. 53-10. 87), respectively, when compared with patients with admission WBC counts <10.0x10 9 /L. Multivariate-adjusted odds ratio (95% con dence intervals) of death associated with WBC 10.0-10.9×10 9 /L, 11.0-11.9×10 9 /L and ≥12.0×10 9 /L were 2.098(0. 96-4. 58), 4.79(2. 24-10. 22) and 5.59(3. 14-9. 98), respectively. Conclusion:Increased WBC count at admission was signi cantly and positively associated with in-hospital death or dependency at discharge among patients with acute cerebral infarction.

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“…A lot of studies have shown that WBC count measured at the time of hospital admission was associated with greater initial stroke severity [10,23,24] and might have a prognostic value in acute stroke survivors [10,25]. Subjects with increased WBC count have excess risk of ischemic strokes independently of other cardiovascular risk factors [26].…”

Section: Discussionmentioning

confidence: 99%

Predictors of In-Hospital Mortality after Acute Ischemic Stroke in Subjects with and without Diabetes Mellitus

Papazafiropoulou¹,

Sotiropoulos²,

Skliros³

et al. 2009

TOGMJ

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Abstract:Background: Diabetes mellitus is a well-established risk factor for ischemic stroke and is associated with increased in-hospital mortality. The aim of the present study was to determine the potential predictors of in-hospital mortality after an ischemic stroke in diabetic and nondiabetic subjects. Methods: 159 diabetic subjects (66 males / 93 females, mean age ± SD: 77.4 ± 6.4 years) and 159 non diabetic subjects (66 males / 93 females, mean age ± SD: 77.3 ± 5.2 years) hospitalized for ischemic stroke were studied. Demographic characteristics and laboratory tests on admission as well as outcome were recorded. Brain computed tomography scan was performed in all study subjects. Results: In-hospital death rates did not differ between the diabetic and the nondiabetic patients [36 (22.6%) vs. 27 (17.0%), respectively, P = 0.20]. In the diabetic study group multivariate analysis, after controlling for CRP, total cholesterol, LDL-C, urea and creatinine levels, demonstrated that death was related with WBC count (OR: 1.002, 95% CI: 1.001-1.004, P = 0.005), glucose levels (OR: 1.007, 95% CI: 1.002-1.012, P = 0.008), and UA levels (OR: 1.51, 95% CI: 1.003-2.260, P = 0.05). In the nondiabetic study group, after controlling for WBC count, CRP, total cholesterol and LDL-C levels, death was related only with glucose levels (OR: 1.016, 95% CI: 1.001-1.031, P = 0.03). Conclusions: WBC count and UA levels on hospital admission are independent predictors for in-hospital mortality in diabetic subjects with ischemic stroke. Plasma glucose levels are predictor for in-hospital mortality in both diabetic and nondiabetic subjects.

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Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients

Cited by 56 publications

References 23 publications

Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates

Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates

Relationship between white blood cell count at admission and short term outcome in patients with acute cerebral infarction

Predictors of In-Hospital Mortality after Acute Ischemic Stroke in Subjects with and without Diabetes Mellitus

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