Thrombolysis in stroke patients with elevated inflammatory markers.

Details

Serval ID
serval:BIB_B9B914077FDE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Thrombolysis in stroke patients with elevated inflammatory markers.
Journal
Journal of neurology
Author(s)
Altersberger V.L., Enz L.S., Sibolt G., Hametner C., Nannoni S., Heldner M.R., Stolp J., Jovanovic D.R., Zini A., Pezzini A., Wegener S., Cereda C.W., Ntaios G., Räty S., Gumbinger C., Heyse M., Polymeris A.A., Zietz A., Schaufelbuehl A., Strambo D., Padlina G., Slavova N., Tiainen M., Valkonen K., Velzen TJV, Bigliardi G., Stanarcevic P., Magoni M., Luft A., Bejot Y., Vandelli L., Padjen V., Nederkoorn P.J., Arnold M., Michel P., Ringleb P.A., Curtze S., Engelter S.T., Gensicke H.
Working group(s)
Thrombolysis in Stroke Patients (TRISP) collaborators
ISSN
1432-1459 (Electronic)
ISSN-L
0340-5354
Publication state
Published
Issued date
10/2022
Peer-reviewed
Oui
Volume
269
Number
10
Pages
5405-5419
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
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).
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 × 10 <sup>9</sup> /l) and leukopenia (WBC < 4 × 10 <sup>9</sup> /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.
Of 10,813 IVT-treated patients, 2527 had leukocytosis, 112 leukopenia and 8174 normal WBC. Increasing WBC (by 1 × 10 <sup>9</sup> /l) predicted poor outcome (OR <sub>adjusted</sub> 1.04[1.02-1.06]) but not mortality and sICH. Leukocytosis was independently associated with poor outcome (OR <sub>adjusted</sub> 1.48[1.29-1.69]) and mortality (OR <sub>adjusted</sub> 1.60[1.35-1.89]) but not with sICH (OR <sub>adjusted</sub> 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 (OR <sub>adjusted</sub> 2.26[1.76-2.91]) and mortality (OR <sub>adjusted</sub> 2.43[1.86-3.16]) when compared to combined normal WBC and CRP.
In IVT-treated patients, leukocytosis independently predicted poor functional outcome and death. Bleeding complications after IVT were not independently associated with leukocytosis.
Keywords
Brain Ischemia/complications, Fibrinolytic Agents/adverse effects, Humans, Leukocytosis, Leukopenia/complications, Prospective Studies, Stroke/complications, Stroke/drug therapy, Stroke/epidemiology, Thrombocytopenia, Thrombolytic Therapy/adverse effects, Treatment Outcome, CRP, Inflammation, Stroke, Thrombolysis, White blood cell count
Pubmed
Web of science
Open Access
Yes
Create date
17/06/2022 14:12
Last modification date
22/09/2022 6:38
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