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

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 first 24 hours of admission. Clinical outcomes (death or dependency) were evaluated by neurologists during hospitalization. The 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% confidence intervals) of dependency associated with patients with WBC of 10.0-10.9×109/L, 11.0-11.9×109/L, ≥12.0×109/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 < 10.0x109/L. Multivariate-adjusted odds ratio (95% confidence intervals) of death associated with WBC 10.0-10.9×109/L, 11.0-11.9×109/L and ≥12.0×109/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 significantly and positively associated with in-hospital death or dependency at discharge among patients with acute cerebral infarction.

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Does Disease Activity After Induction Treatment With Biologics Predict Short-Term Outcome in Crohn’s Disease and Ulcerative Colitis?

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab331 ◽

2022 ◽

Author(s):

Michael Due Larsen ◽

Bente Mertz Nørgård ◽

Jens Kjeldsen

Keyword(s):

Disease Activity ◽

Induction Therapy ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Biologic Therapy ◽

C Reactive Protein ◽

Short Term ◽

Term Outcome ◽

Reactive Protein ◽

Short Term Outcome

Abstract Background Secondary loss of response to biological therapy is a challenge when treating Crohn’s disease (CD) and ulcerative colitis (UC). Currently, no single marker has been found to be valid as a prognostic indicator of response to biologic therapy in patients with CD and UC. In this study, we aimed to assess whether disease activity after 14 weeks of biologic therapy has a prognostic impact on surgery and steroid-free remission during 6 months following completion of induction therapy. Methods In an unselected cohort study based on data from 4 national Danish health registries, we identified 493 patients with UC and 620 patients with CD who completed induction therapy with biologics from 2016 to 2019. Following induction therapy with biologics, we defined disease activity based on C-reactive protein and clinical scores of disease activity. The composite endpoint, “not being well treated,” included surgery or use of corticosteroid within 6 months following induction therapy. Results In patients with UC with disease activity following induction therapy, the adjusted odds ratio for surgery or steroid treatment during 6 months of follow-up was 3.9 (95% CI, 1.6-9.3) compared with patients without disease activity, and in patients with CD, the adjusted odds ratio was 3.6 (95% CI, 1.7-7.6). Conclusions A positive treatment response to biologic treatment after induction therapy (measured by C-reactive protein and clinical scores) predicts a better short-term outcome in patients with CD and UC.

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Preadmission Use of Warfarin Improves Short-Term Outcome in Patients with Acute Cerebral Infarction

Cerebrovascular Diseases ◽

10.1159/000215937 ◽

2009 ◽

Vol 28 (1) ◽

pp. 8-12 ◽

Cited By ~ 3

Author(s):

Halvor Naess ◽

Jan Brogger ◽

Ulrike Waje-Andreassen ◽

Titto T. Idicula ◽

Lars Thomassen

Keyword(s):

Cerebral Infarction ◽

Acute Cerebral Infarction ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome

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Persistent Atrial Fibrillation Is Associated with Worse Prognosis Than Paroxysmal Atrial Fibrillation in Acute Cerebral Infarction

ISRN Cardiology ◽

10.5402/2012/650915 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Halvor Naess ◽

Ulrike Waje-Andreassen ◽

Lars Thomassen

Keyword(s):

Atrial Fibrillation ◽

Cerebral Infarction ◽

Persistent Atrial Fibrillation ◽

Stroke Onset ◽

Acute Cerebral Infarction ◽

Short Term ◽

Term Outcome ◽

Nihss Score ◽

Short Term Outcome ◽

Clot Structure

Background and Purpose. We hypothesized that patients with persistent atrial fibrillation (AF) suffer from more severe cerebral infarction than patients with paroxysmal AF due to differences in clot structure and volume. Methods. This study includes consecutive patients with acute cerebral infarction and persistent or paroxysmal AF documented by ECG any time prior to stroke onset. The National Institute of Health Stroke Scale (NIHSS) was used to assess stroke severity on admission. Short-term outcome was determined by the modified Rankin scale (mRS) score, Barthel index, and NIHSS score 7 days after stroke onset. Risk factors were registered on admission. Eligible patients were treated with thrombolysis. Results. In total, 141 (52%) patients had paroxysmal AF, and 129 (48%) patients had persistent AF. NIHSS score on admission, mRS score at day 7, and mortality were significantly higher among patients with persistent AF. Thrombolysis was less effective in patients with persistent AF. Conclusions. Our study shows that patients with persistent AF and acute cerebral infarction have poorer short-term outcome than patients with paroxysmal AF. Differences in clot structure or clot volume may explain this.

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Role of some inflammatory biomarkers in prediction of short-term outcome in acute ischemic stroke

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00294-4 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Yosria Abd Al Hameed AlTaweel ◽

Rania Sanad Nageeb ◽

Pakinam Mahmoud Metwally ◽

Ahmed Elsayed Badawy

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Severity ◽

Short Term ◽

Laboratory Assessment ◽

Term Outcome ◽

Neutrophil Lymphocyte Ratio ◽

Short Term Outcome ◽

Wbc Count

Abstract Background Several factors affect acute ischemic stroke (AIS) outcomes. Objective This study aimed to assess the role of the leukocyte count, neutrophil/lymphocyte ratio (NLR), and c reactive protein (CRP) as early predictors of outcome in AIS patients. Methods This study was conducted on 60 AIS patients. They were subjected to detailed history taking, clinical examination, brain imaging, and laboratory assessment including the CRP, white blood cell (WBC) count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR which is calculated by dividing ANC by ALC. Neurological scales were used to assess the level of consciousness by the Glasgow Coma Scale (GCS) and stroke severity by the National Institute of Health Stroke Scale (NIHSS) at the first 48 h of stroke onset as well as 1 week and 2 weeks later for the assessment of short-term functional neurological outcome. Results Sixty percent of the patients had unfavorable outcomes assessed by the Modified Rankin Scale (mRS). Patients with unfavorable outcomes had higher NIHSS scores. NLR was positively correlated with WBC count, ANC, and CRP. The higher WBC, NLR, and NIHSS, the unfavorable the outcome was. Conclusion The higher WBC, the NLR, and the level of CRP at the onset of AIS, the more severe stroke and the poorer the short-term outcome are expected.

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Comparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome

Vascular Health and Risk Management ◽

10.2147/vhrm.s22950 ◽

2011 ◽

pp. 497 ◽

Cited By ~ 11

Author(s):

Halvor Naess ◽

Romi

Keyword(s):

Spinal Cord ◽

Cerebral Infarction ◽

Clinical Characteristics ◽

Spinal Cord Infarction ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome

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Incidence and Short-Term Outcome of Cerebral Infarction in Young Adults in Western Norway

Stroke ◽

10.1161/01.str.0000023888.43488.10 ◽

2002 ◽

Vol 33 (8) ◽

pp. 2105-2108 ◽

Cited By ~ 54

Author(s):

H. Naess ◽

H.I. Nyland ◽

L. Thomassen ◽

J. Aarseth ◽

G. Nyland ◽

...

Keyword(s):

Young Adults ◽

Cerebral Infarction ◽

Short Term ◽

Term Outcome ◽

Western Norway ◽

Short Term Outcome

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Abstract 29: Initial NIHSS Predicts Poor Short-term Outcome After Minor Stroke Even at Very Low Scores

Stroke ◽

10.1161/str.43.suppl_1.a29 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Jonathan M Raser ◽

Arthur Z Washington ◽

Koto Ishida ◽

Christina A Wilson ◽

Swaroop A Pawar ◽

...

Keyword(s):

Ischemic Stroke ◽

Substantial Proportion ◽

Minor Stroke ◽

Hospital Death ◽

Short Term ◽

Term Outcome ◽

Poor Outcome ◽

Short Term Outcome ◽

Minor Ischemic Stroke ◽

Iv Tpa

Background: Minor ischemic stroke patients often do not receive IV tPA due to mild or rapidly resolving symptoms as it is assumed that they will have excellent outcomes without treatment. Nevertheless, a substantial proportion of these patients have a poor outcome. It is unclear if this is due to factors such as preexisting disability, medical comorbidities, or recurrent stroke, or due to the deficits associated with the minor stroke, We hypothesized that initial stroke severity would predict poor short-term outcome even when the deficits are mild. Methods: We conducted a retrospective cohort study based on chart review of all patients with minor ischemic stroke, as defined by NIHSS≤6 at presentation, who were admitted to our hospital over a 30-month time period. Poor short-term outcome was defined by in-hospital death or discharge to any destination other than home. Results: Data were complete for 461 of 471 patients with minor stroke. A substantial proportion, 38% (95%CI 34-43%), had a poor short-term outcome, including 31% discharged to rehabilitation, 5% discharged to a nursing facility, and 2% dead or discharged to hospice. Impaired ambulation prior to admission was associated with a poor outcome (OR 3.4; 95%CI 1.1-10, p<0.03), but only present in 3% of patients. In multivariable analysis, poor outcome was strongly associated with initial NIHSS ( figure ; OR 1.5; 95%CI 1.3-1.7, p<0.001) and age (OR 1.04; 95%CI 1.03-1.06, p<0.001). Similarly, NIHSS predicted poor outcome when analysis was limited to initial NIHSS≤3 (OR 1.8; 95%CI 1.3-2.4, p<0.001). Of the 112 patients presenting within 4.5 hours of time last seen well, 15% received IV tPA and 45% were excluded solely due to mild or rapidly improving symptoms. NIHSS was lower in those patients excluded than in those who received tPA (median 2 vs. 5, p<0.001). After adjustment for age, NIHSS, and prior ambulatory status, there was no significant difference in poor outcome, which occurred in 42% of patients treated with tPA and 24% of those excluded due to mild or rapidly improving symptoms (OR 1.9 for poor outcome after tPA; 95%CI 0.4-9.5, p=0.43). Conclusions: More than one-third of patients with minor stroke had a poor short-term outcome, including nearly one-fourth of those who were excluded from IV tPA due to mild or rapidly improving symptoms. NIHSS was predictive of poor outcome at very low scores, consistent with the hypothesis that the deficits due to the initial stroke were responsible for poor outcome. However, the impact of tPA treatment in this population is uncertain.

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Pattern of Stroke and Short Term Outcome of COVID-19 Patients admitted in a Dedicated Stroke Unit at Referral Neurology Hospital of Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v7i1.54747 ◽

2021 ◽

Vol 7 (1) ◽

pp. 25-28

Author(s):

Subir Chandra Das ◽

Rajib Nayan Chowdhury ◽

Md Moniruzzaman ◽

Mohammad Enayet Hussain ◽

Quazi Deen Mohammad ◽

...

Keyword(s):

Urban Areas ◽

Stroke Unit ◽

Hemorrhagic Stroke ◽

Hospital Death ◽

P Value ◽

Short Term ◽

Term Outcome ◽

Altered Level ◽

Short Term Outcome ◽

Ct Brain

Background: COVID-19 was declared as a pandemic by WHO on March 11, 2020. Though the most common and important presentation is with respiratory disease, reports of neurological features are increasing. Objective: In this study it was described the pattern of stroke in COVID-19 patients admitted in a dedicated stroke unit and their short term outcome. Methodology: This single arm, single centreprospective cohortstudy was conducted in the Stroke Unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from April to August, 2020 and wasincluded acute stroke patients irrespective of age and sex who were found RT-PCR positive for SARS CoV-2. The patientswere evaluated clinically, biochemically and by imaging. After diagnosis patients were referred to a COVIDdedicated hospital and were followed up over phone for 4 weeks from the day of admission in stroke unit to assess short term outcome. Results: Among the 41 patients, 21 were male and 20 female with an age range of 26 to 90 years where 58.5% patients were aged 60 and above. Majority (58.5%) of them came from different urban areas. Common co-morbidities were Hypertension (68.3%) and Diabetes mellitus (39%). Most common presenting features were hemiplegia (48.8%) and altered level of consciousness (39%). More than seventy percent (70.7%) patients had GCS of 10 or less and 56.1% patients had oxygen saturation 90% or less in room air. CT brain imaging revealed infarct in 39% and hemorrhage in 51.2%. Chest radiography revealed abnormality in 14.6% cases. Regarding the short term outcome, total 20 (48.8%) patients died where 7 died before referral to COVID-19 dedicated hospital. Death was higher in hemorrhagic stroke but there was no significant association between outcome and the type of stroke (p value>0.05). Conclusions: Hemorrhagic stroke is the most commonly occurring stroke among the COVID-19 patients and associated with p oor outcome. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 25-28

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