Prognostic impact of leukocytosis in intracerebral hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is correlated with high rate of death and poor outcome. Leukocytes participate in secondary brain injury in ICH. It is still not clear that whether leukocytosis can predict outcome in ICH. This study was performed to summarize that current evidences about the association between baseline leukocytosis and outcome in ICH patients in a systematic review and meta-analysis. Methods: Published studies were searched in 5 databases. Original studies about association between baseline leukocytosis and outcome in ICH were included. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were achieved to evaluate the association between leukocytosis and prognosis. Results: A total of 19 eligible studies with 6417 patients were analyzed in this study. Meta-analysis showed baseline leukocyte count increase was significantly associated with worse overall (OR = 1.13, 95% CI 1.05–1.21, P = .001), short-term (OR = 1.20, 95% CI 1.05–1.38, P = .009), and long-term functional outcome (OR = 1.12, 95% CI 1.04–1.20, P = .004). Baseline leukocytosis defined by cut-off values had significant association with worse overall functional outcome (OR = 1.95, 95% CI 1.01–3.76, P = .046). Baseline leukocyte count increase was significantly associated with higher overall (OR = 1.10, 95% CI 1.02–1.18, P = .011) and long-term mortality (OR = 1.12, 95% CI 1.03–1.22, P = .007). Baseline leukocytosis defined by cut-off values was significantly associated with higher overall (OR = 1.67, 95% CI 1.23–2.27, P = .001) and short-term mortality (OR = 1.74, 95% CI 1.12–2.70, P = .014). Conclusion: Baseline leukocytosis could be helpful in predicting prognosis in ICH patients. However, its prognostic value should be verified by further studies.

Clinical and paraclinical predictors of early neurological deterioration and poor outcome in spontaneous intracerebral hemorrhage

“…It was reported that large hematoma volume is considered a strong predictor of poor outcome [ 32 – 34 ]. The same was reported regarding leukoaraiosis [ 35 – 37 ]. This can be explained by the fact that white matter lesions (WML) may indicate small vessel disease (SVD) and loss of vascular and blood–brain barrier integrity, demyelination, arteriosclerosis, myelin loss, gliosis, and spongiosis, leading to an increased risk of hematoma enlargement (HE).…”

Clinicoradiological and Biochemical Predictors of Mortality in Hospitalized Patients of Spontaneous Intracerebral Hemorrhage

“…Site of hemorrhage though did not differ statistically among the patients who survived versus who died similar to previous studies by Bhatia et al 6 and Togha and Bakhtavar. 17 Leucocytosis is associated with increased mortality in ICH patients similar to the results of meta-analysis done by Yu et al 18 as it might point toward septicemia. Our study showed that raised creatinine level and hypernatremia was significantly associated with mortality.…”

Exosomes From miR-19b-3p-Modified ADSCs Inhibit Ferroptosis in Intracerebral Hemorrhage Mice

“…Intracerebral hemorrhage (ICH), which is defined as the spontaneous extravasation of blood into the brain parenchyma, is a devastating kind of stroke with high disability and mortality rates ( Zhang et al, 2013 ; Yu et al, 2019 ). Current knowledge of post-ICH neuronal death and related mechanisms is limited.…”