Thrombolysis in stroke patients with elevated inflammatory markers

Objective 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). Methods In this prospective multicenter study from the TRISP registry, we assessed the association between...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of neurology Jg. 269; H. 10; S. 5405 - 5419
Hauptverfasser: Altersberger, Valerian L., Enz, Lukas S., Sibolt, Gerli, Hametner, Christian, Nannoni, Stefania, Heldner, Mirjam R., Stolp, Jeffrey, Jovanovic, Dejana R., Zini, Andrea, Pezzini, Alessandro, Wegener, Susanne, Cereda, Carlo W., Ntaios, George, Räty, Silja, Gumbinger, Christoph, Heyse, Miriam, Polymeris, Alexandros A., Zietz, Annaelle, Schaufelbuehl, Anna, Strambo, Davide, Padlina, Giovanna, Slavova, Nedelina, Tiainen, Marjaana, Valkonen, Kati, Velzen, Twan J. van, Bigliardi, Guido, Stanarcevic, Predrag, Magoni, Mauro, Luft, Andreas, Bejot, Yannick, Vandelli, Laura, Padjen, Visnja, Nederkoorn, Paul J., Arnold, Marcel, Michel, Patrik, Ringleb, Peter A., Curtze, Sami, Engelter, Stefan T., Gensicke, Henrik
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2022
Springer Nature B.V
Schlagworte:
Bleeding
C-reactive protein
Hemorrhage
Inflammation
Intravenous administration
Leukocytosis
Leukopenia
Medicine
Medicine & Public Health
Mortality
Neurology
Neuroradiology
Neurosciences
Original Communication
Regression analysis
Stroke
Thrombolysis
Thrombolytic drugs
CRP
Stroke
Inflammation
White blood cell count
Thrombolysis
ISSN:0340-5354, 1432-1459, 1432-1459
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Objective 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). Methods 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 9 /l) and leukopenia (WBC < 4 × 10 9 /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. Results Of 10,813 IVT-treated patients, 2527 had leukocytosis, 112 leukopenia and 8174 normal WBC. Increasing WBC (by 1 × 10 9 /l) predicted poor outcome (OR adjusted 1.04[1.02–1.06]) but not mortality and sICH. Leukocytosis was independently associated with poor outcome (OR adjusted 1.48[1.29–1.69]) and mortality (OR adjusted 1.60[1.35–1.89]) but not with sICH (OR adjusted 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 adjusted 2.26[1.76–2.91]) and mortality (OR adjusted 2.43[1.86–3.16]) when compared to combined normal WBC and CRP. Conclusion In IVT-treated patients, leukocytosis independently predicted poor functional outcome and death. Bleeding complications after IVT were not independently associated with leukocytosis.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:0340-5354
1432-1459
1432-1459
DOI:10.1007/s00415-022-11173-0