Abstract
Background and Purpose
Leukocytosis is a reaction that is usually, but not always, associated with an infectious process. There is very little data on the significance of admission leukocytosis (AL) in patients with intracerebral hemorrhage (ICH). The purpose of this study was to investigate the associated clinical and radiologic findings and prognostic significance of AL in patients with ICH.
Methods
We retrospectively reviewed the records of consecutive ICH patients admitted over a 2-year period. Key data we collected included ICH size, location, intraventricular hemorrhage (IVH), age, admission Glasgow Coma Scale (GCS0) score, peak leukocyte count and temperature in the first 24 h of hospitalization, and outcomes on discharge. Severity of IVH was calculated using the Graeb Scale. Logistic regression was performed to determine association of variables.
Results
In 128 consecutive ICH patients, AL was present in 41.4 %. AL was significantly associated with presence (OR 2.28, 95 % CI 1.11–4.68; p = 0.024), but not severity of IVH and with admission GCS0. Leukocyte count showed a strong association with IVH (p = 0.01) and with decreasing GCS0 (p = 0.007). There was no correlation between AL and poor outcome at discharge. There was also no evidence of infection in any patient with AL.
Conclusion
AL in ICH patients is often non-infectious, strongly associated with the presence of IVH, but not specifically an ominous indicator for outcome. Leukocyte count has an inverse relationship with GCS0. Prospective studies are needed to confirm these findings.
Similar content being viewed by others
References
Hocker SE, Tian L, Li G, Steckelberg JM, et al. Indicators of central fever in the neurologic intensive care unit. JAMA Neurol. 2013;70:1499–504.
Sun W, Peacock A, Becker J, et al. Correlation of leukocytosis with early neurological deterioration following supratentorial intracerebral hemorrhage. J Clin Neurosci. 2012;19:1096–100.
Kothari RU, Brott T, Broderick JP, et al. The ABCs of measuring intracerebral hemorrhage volumes. Stroke. 1996;27:1304–5.
Graeb DA, Robertson WD, Lapointe JS, et al. Computed tomographic diagnosis of intraventricular hemorrhage. Etiology and prognosis. Radiology. 1982;143:91–6.
Neil-Dwyer G, Cruickshank J. The blood leucocyte count and its prognostic significance in subarachnoid haemorrhage. Brain. 1974;97:79–86.
Wang J, Doré S. Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2007;27:894–908.
Schwarz S, Häfner K, Aschoff A, Schwab S. Incidence and prognostic significance of fever following intracerebral hemorrhage. Neurology. 2000;54:354–61.
Chang DC, Cornwell EE 3rd, Phillips J, Paradise J, Campbell K. Early leukocytosis in trauma patients: what difference does it make? Curr Surg. 2003;60:632–5.
Suzuki S, Kelley RE, Dandapani BK, et al. Acute leukocyte and temperature response in hypertensive intracerebral hemorrhage. Stroke. 1995;26:1020–3.
Conflict of interest
The authors have nothing to disclose and no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Behrouz, R., Hafeez, S. & Miller, C.M. Admission Leukocytosis in Intracerebral Hemorrhage: Associated Factors and Prognostic Implications. Neurocrit Care 23, 370–373 (2015). https://doi.org/10.1007/s12028-015-0128-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12028-015-0128-7