scholarly journals Combined utility of white blood cell count and blood glucose for predicting in-hospital outcomes in acute ischemic stroke

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Shoujiang You ◽  
Zhijie Ou ◽  
Wei Zhang ◽  
Danni Zheng ◽  
Chongke Zhong ◽  
...  
2021 ◽  
Vol 10 (8) ◽  
pp. 1610
Author(s):  
Marcin Wnuk ◽  
Justyna Derbisz ◽  
Leszek Drabik ◽  
Agnieszka Slowik

Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced divergent results. We evaluated whether C-reactive protein (CRP) and white blood cell count (WBC) measured fasting 12–24 h after intravenous thrombolysis (IVT) were associated with outcome in AIS patients without concomitant infection. Methods: The study included 352 AIS patients treated with IVT. Excluded were patients with community-acquired or nosocomial infection. Outcome was measured on discharge and 90 days after stroke onset with the modified Rankin scale (mRS) and defined as poor outcome (mRS 3–6) or death (mRS = 6). Results: Final analysis included 158 patients (median age 72 years (interquartile range 63-82), 53.2% (n = 84) women). Poor outcome on discharge and at day 90 was 3.8-fold and 5.8-fold higher for patients with CRP ≥ 8.65 mg/L (fifth quintile of CRP), respectively, compared with first quintile (<1.71 mg/L). These results remained significant after adjustment for potential confounders (odds ratio (OR) on discharge = 10.68, 95% CI: 2.54–44.83, OR at day 90 after stroke = 7.21, 95% CI: 1.44–36.00). In-hospital death was 6.3-fold higher for patients with fifth quintile of CRP as compared with first quintile and remained independent from other variables (OR = 4.79, 95% CI: 1.29–17.88). Independent predictors of 90-day mortality were WBC < 6.4 × 109 /L (OR = 5.00, 95% CI: 1.49–16.78), baseline National Institute of Health Stroke Scale (NIHSS) score (OR = 1.13 per point, 95% CI: 1.01–1.25) and bleeding brain complications (OR = 5.53, 95% CI: 1.59–19.25) but not CRP ≥ 8.65 mg/L. Conclusions: Non-infective CRP levels are an independent risk factor for poor short- and long-term outcomes and in-hospital mortality in AIS patients treated with IVT. Decreased WBC but not CRP is a predictor for 90-day mortality.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kyohei Fujita ◽  
Shoichiro Sato ◽  
Sohei Yoshimura ◽  
Toshihiro Ide ◽  
Takeshi Yoshimoto ◽  
...  

Background and Purpose: White blood cell count (WBC), a marker of the atherosclerotic burden, has reportedly been a predictor of poor outcome in the general stroke population. The purpose of this study was to clarify associations between WBC on admission and outcomes among patients having acute ischemic stroke with nonvalvular atrial fibrillation (NVAF), that was principally cardioembolic. Methods: Of those enrolled in the multicenter observational Stroke Acute Management with Urgent Risk-factor Assessment and Improvement (SAMURAI)-NVAF study, acute ischemic stroke/TIA patients (within 7 days of onset) with NVAF with premorbid modified Rankin Scale (mRS) score of 0-2 were included in the analysis. WBC on admission was categorized into quartiles. Associations between WBC count and major disability or death (mRS score of 3-6) at 90 days and 2 years were analyzed using logistic and proportional odds regression models. Results: A total of 789 patients were studied (306 women, 76.2±9.5 years old, the median NIHSS score was 6 [IQR, 2-16], the median WBC count was 6700 [IQR, 5475-8300], the median mRS score at 90 days was 2 [IQR, 1-4], the median mRS score at 2 years was 2 [IQR, 0-5]). WBC had a significant linear association with major disability or death at 90 days (adjusted odds ratio [OR] for highest versus lowest quartile 3.53; 95% confidence interval [CI] 2.07-6.13; P for trend<0.001). Associations were similar for the outcome at 2 years (adjusted OR for highest versus lowest quartile 2.16; 95% CI 1.31-3.56; P for trend<0.001). Conclusions: Higher WBC count on admission seems to predict a short- and long-term poor outcome in acute ischemic stroke patients with NVAF. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01581502.


ISRN Stroke ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Latha Ganti ◽  
Rachel M. Gilmore ◽  
Amy L. Weaver ◽  
Robert D. Brown

Objective. To determine whether routine laboratory parameters are predictors of early mortality after acute ischemic stroke (AIS). Methods. The cohort consisted of 522 consecutive patients with AIS presenting to the emergency department (ED) at a tertiary referral center during a 27-month period, residing within the surrounding ten counties. Serum laboratory values were obtained for all patients and categorized according to whether the levels were low, normal, or high. These laboratory results were evaluated as potential predictors of 90-day mortality using Cox proportional hazards models. The associations were summarized by calculating risk ratios (RRs) and 95% confidence intervals (CI). Results. The presence of elevated white blood cell count (RR 2.2, 95% CI 1.5–3.4), low bicarbonate (RR 4.2, 95% CI 2.6–6.7), low calcium (RR 2.9, 95% CI 1.4–5.9), and high glucose (RR 1.3, 95% 1.1–1.6) were each univariately associated with significantly higher mortality within the first 90 days. Based on fitting a multivariate Cox regression model, elevated white blood cell count, low bicarbonate, and high glucose were each identified as being jointly associated with early mortality (). Conclusion. Early leukocytosis, acidosis, and hyperglycemia and hypocalcemia in AIS appear to be associated with early mortality. Whether addressing these factors will impact survival remains to be investigated.


2020 ◽  
Vol 03 (01) ◽  
pp. e1-e5
Author(s):  
Naoya Fujikawa ◽  
Taku Yamashita

Abstract Background Based on the background factors and results of blood tests in patients with peritonsillar abscess, we investigated the factors involved in the prolongation of hospitalization and progression to deep neck abscess of these patients. Objective and Methods We studied the data of 113 patients with peritonsillar abscesses (including those in whom the condition progressed to deep neck abscesses) who were hospitalized at our department during the 3-year period from August 2014 to August 2017. Data of patients who needed hospitalized treatment for 7 days or more, including the age, body mass index (BMI), sickness period, white blood cell count, serum C-reactive protein (CRP), serum total protein, serum albumin, blood glucose, blood HbA1c, and estimated glomerular filtration rate (eGFR) at the first examination, and the neck factors in the cases that progressed to deep cervical abscess were examined using t-tests. Results The blood test items and background factors at the first visit were compared according to the length of hospitalization. The results revealed that prolonged hospitalization was associated with higher values of age, peripheral blood white blood cell count, serum CRP value and blood glucose, and lower values of serum total protein, serum albumin, and eGFR. Conclusions Factors that were associated with a longer hospital stay in this study were relatively high values of age, peripheral blood white blood cell count, blood glucose and serum CRP, and relatively low values of the serum total protein, serum albumin, and eGFR. The disease duration, BMI, and HbA1c were not identified as significant factors. Stepwise multiple regression analysis to identify factors associated with prolonged hospitalization identified the blood glucose and serum albumin levels measured at the first visit as significant predictors of a prolonged hospital stay and higher severity of the illness. Our findings suggested the importance of measuring these factors for predicting the progression to deep cervical abscess.


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