Titre
Thrombolysis in stroke patients with elevated inflammatory markers.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Altersberger, V.L.
Auteure/Auteur
Enz, L.S.
Auteure/Auteur
Sibolt, G.
Auteure/Auteur
Hametner, C.
Auteure/Auteur
Nannoni, S.
Auteure/Auteur
Heldner, M.R.
Auteure/Auteur
Stolp, J.
Auteure/Auteur
Jovanovic, D.R.
Auteure/Auteur
Zini, A.
Auteure/Auteur
Pezzini, A.
Auteure/Auteur
Wegener, S.
Auteure/Auteur
Cereda, C.W.
Auteure/Auteur
Ntaios, G.
Auteure/Auteur
Räty, S.
Auteure/Auteur
Gumbinger, C.
Auteure/Auteur
Heyse, M.
Auteure/Auteur
Polymeris, A.A.
Auteure/Auteur
Zietz, A.
Auteure/Auteur
Schaufelbuehl, A.
Auteure/Auteur
Strambo, D.
Auteure/Auteur
Padlina, G.
Auteure/Auteur
Slavova, N.
Auteure/Auteur
Tiainen, M.
Auteure/Auteur
Valkonen, K.
Auteure/Auteur
Velzen, TJV
Auteure/Auteur
Bigliardi, G.
Auteure/Auteur
Stanarcevic, P.
Auteure/Auteur
Magoni, M.
Auteure/Auteur
Luft, A.
Auteure/Auteur
Bejot, Y.
Auteure/Auteur
Vandelli, L.
Auteure/Auteur
Padjen, V.
Auteure/Auteur
Nederkoorn, P.J.
Auteure/Auteur
Arnold, M.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Ringleb, P.A.
Auteure/Auteur
Curtze, S.
Auteure/Auteur
Engelter, S.T.
Auteure/Auteur
Gensicke, H.
Auteure/Auteur
Groupes de travail
Thrombolysis in Stroke Patients (TRISP) collaborators
Liens vers les personnes
Liens vers les unités
ISSN
1432-1459
Statut éditorial
Publié
Date de publication
2022-10
Volume
269
Numéro
10
Première page
5405
Dernière page/numéro d’article
5419
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
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.
PID Serval
serval:BIB_B9B914077FDE
PMID
Open Access
Oui
Date de création
2022-06-17T12:12:13.015Z
Date de création dans IRIS
2025-05-21T00:46:49Z
Fichier(s)![Vignette d'image]()
En cours de chargement...
Nom
35622132_BIB_B9B914077FDE.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
706.93 KB
Format
Adobe PDF
PID Serval
serval:BIB_B9B914077FDE.P001
URN
urn:nbn:ch:serval-BIB_B9B914077FDE5
Somme de contrôle
(MD5):32a0fbc7826707d510d4b2213b32d33e