Background
Leukocytosis is associated with hemorrhage volume and early neurologic deterioration
after intracerebral hemorrhage (ICH). We examined total white blood cell (WBC) count,
absolute monocyte count (AMC), and absolute neutrophil count (ANC) as potential readily
available prognostic biomarkers in human ICH.
Methods
In a retrospective study, adult patients aged 18 years or older who presented to 1
of 2 local hospitals with nontraumatic ICH from July 2008 to December 2009 within
12 hours of symptom onset were identified. Demographics, Glasgow Coma Scale (GCS),
ICH volume, ICH location, and 30-day case fatality rates were determined. Total WBC
count, ANC, AMC, and hemoglobin concentration were determined. Linear and logistic
regressions were used to evaluate factors associated with baseline ICH volume (log
transformed) and 30-day case fatality, respectively.
Results
Of the 186 patients, mean (±SD) age was 67.3 ± 14.8 years; 51% were men and 22% were
black. Median (interquartile range) ICH volume was 12.8 (4.9, 29.4) mL. After adjusting
for patient age and initial hemoglobin, higher initial WBC count (P = .0009) and higher ANC (P = .006) were associated with higher ICH volume, whereas AMC was not (P = .4). After adjusting for patient age, GCS, intraventricular hemorrhage (+/−), stroke
location, and ICH volume, baseline AMC was associated with greater odds of 30-day
case fatality (odds ratio 2.26, 95% confidence interval 1.10-4.65, P = .03).
Conclusions
The association of AMC with higher 30-day case fatality after ICH is hypothesis generating.
Given the lack of association between presenting AMC and ICH volume, AMC may contribute
to secondary injury after ICH (hematoma expansion and/or cerebral edema).
Key Words
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Article info
Publication history
Published online: October 10, 2013
Accepted:
September 5,
2013
Received in revised form:
August 29,
2013
Received:
July 5,
2013
Footnotes
This study was funded by the National Institutes of Health/National Institutes of Neurological Disorders and Stroke (grant #NS036695).
Conflict of interest: All authors report no conflicts of interest.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.09.006
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
