We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Thrombolysis in stroke patients with elevated inflammatory markers.
- Authors
Altersberger, Valerian L.; Enz, Lukas S.; Sibolt, Gerli; Hametner, Christian; Nannoni, Stefania; Heldner, Mirjam R.; Stolp, Jeffrey; Jovanovic, Dejana R.; Zini, Andrea; Pezzini, Alessandro; Wegener, Susanne; Cereda, Carlo W.; Ntaios, George; Räty, Silja; Gumbinger, Christoph; Heyse, Miriam; Polymeris, Alexandros A.; Zietz, Annaelle; Schaufelbuehl, Anna; Strambo, Davide
- Abstract
Objective: To investigate the prognostic value of white blood cell count (WBC) on functional outcome, mortality and bleeding risk in stroke patients treated with intravenous thrombolysis (IVT). Methods: In this prospective multicenter study from the TRISP registry, we assessed the association between WBC on admission and 3-month poor outcome (modified Rankin Scale 3–6), mortality and occurrence of symptomatic intracranial hemorrhage (sICH; ECASS-II-criteria) in IVT-treated stroke patients. WBC was used as continuous and categorical variable distinguishing leukocytosis (WBC > 10 × 109/l) and leukopenia (WBC < 4 × 109/l). We calculated unadjusted/ adjusted odds ratios with 95% confidence intervals (OR [95% CI]) with logistic regression models. In a subgroup, we analyzed the association of combined leukocytosis and elevated C-reactive protein (CRP > 10 mg/l) on outcomes. Results: Of 10,813 IVT-treated patients, 2527 had leukocytosis, 112 leukopenia and 8174 normal WBC. Increasing WBC (by 1 × 109/l) predicted poor outcome (ORadjusted 1.04[1.02–1.06]) but not mortality and sICH. Leukocytosis was independently associated with poor outcome (ORadjusted 1.48[1.29–1.69]) and mortality (ORadjusted 1.60[1.35–1.89]) but not with sICH (ORadjusted 1.17[0.94–1.45]). Leukopenia did not predict any outcome. In a subgroup, combined leukocytosis and elevated CRP had the strongest association with poor outcome (ORadjusted 2.26[1.76–2.91]) and mortality (ORadjusted 2.43[1.86–3.16]) when compared to combined normal WBC and CRP. Conclusion: In IVT-treated patients, leukocytosis independently predicted poor functional outcome and death. Bleeding complications after IVT were not independently associated with leukocytosis.
- Subjects
LEUKOCYTE count; STROKE patients; THROMBOLYTIC therapy; LEUCOPENIA; INTRACRANIAL hemorrhage
- Publication
Journal of Neurology, 2022, Vol 269, Issue 10, p5405
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-022-11173-0