The Immature Granulocyte Count Is a New Predictor of the 30-Day Mortality in Intracerebral Haemorrhage Patients: Preliminary Study

Abstract

Objectives Spontaneous intracerebral hemorrhage (ICH) accounts for 10 to 20% of all types of stroke and is associated with high mortality and morbidity rates. Neuroinflammation caused by intracerebral blood includes resident microglia activation, infiltration of systemic immune cells, and production of cytokines, chemokines, extracellular proteases, and reactive oxygen species. Despite several findings demonstrating that an immature granulocyte (IG) count can be a prognostic indicator as an inflammatory parameter in many diseases, no studies conducted on ICH patients are available in the literature. Therefore, in this study, we aimed to investigate the relationship between the 30-day mortality rate and the IG count obtained at the time of admission in ICH patients. Methods Demographic characteristics and laboratory test results of patients, who were diagnosed with ICH and hospitalized accordingly upon arrival at the emergency ward in our tertiary care hospital in the period from January 2019 and December 2019, were recorded. The endpoint of the study was the examination of the relationship between the short-term mortality (within 30 days after hospitalization) and the IG count at admission. Results Seventy patients, who met the inclusion criteria, were included in the study. Of these patients, 40 (57.1%) were males and the mean age was 68.04 ± 13.08 years. Patients with poor prognosis had higher IG counts (p = 0.001). The 30-day mortality rate was 33.3% (11/33) in the high IG count (≥0.6) group and 5.4% (2/37) in the low IG count (< 0.6) group (p = 0.004). In the regression analysis, we found out a significant relationship of the IG count to the 30-day mortality, with an odds ratio of 5.157(95% CI = 0.914–29.087, p = 0.029). Conclusion An IG count can be obtained from a simple full blood count, is easy to apply, does not result in extra costs, and is used as a marker to predict the 30-day prognosis.

Usefulness of Immature Granulocytes as A Prognostic Factor in ST-Elevation Myocardial Infarction

“…The IG count is less known among physicians, but it is a simple haemogram parameter. Several studies have recently suggested that the IG count can be used to predict both the short- and long-term mortality associated with many diseases [ 12 , 13 ] . The present study has shown that the IG count is an independent risk factor that can be used to predict the prognosis in patients with STEMI.…”

“…Inflammation and trauma are known to lead to the occurrence of circulating immature cells that normally should not be present in the peripheral blood. Therefore, the diagnostic and prognostic values of circulating immature cells in sepsis, trauma, and gastrointestinal system diseases have been discussed in many studies [ 12 , 20 , 21 ] . Krishnan et al [ 22 ] reported that the IG count was an effective marker in predicting the severity of the infection and determining the need for early intervention in critically ill patients.…”

Immature granulocyte in prediction of the short-term and long-term mortality of patients with acute myocardial infarction

“…In other words, it does not require an extra effort, cost and time. Several recent studies have shown that IG can be used to predict short-term mortality [38,39]. In a recent study, it was shown that IG number predicts mortality in upper gastrointestinal system diseases with a cut-off value of 0.95 with a sensitivity of 66.7% and a specificity of 75.7% [11].…”

Immature granulocyte and other markers in prediction of mortality in spontaneous intracerebral hemorrhage

“…Moreover, in one study, IG was associated with 30-day mortality in acute ischemic stroke (5). However, there is only one study on IG in the literature to predict mortality in patients with SICH, and the relationship between 30-day mortality and IG has been investigated (6). Therefore, in this study, we aimed to investigate the role of IG obtained at admission in predicting in-hospital mortality in patients with SICH.…”