Relationship between leukocyte counts and large vessel occlusion in acute ischemic stroke
| Autor: | László Csiba, Zsofia Szabo, Zsofia Nozomi Karadi, István Szegedi, László Szapáry, Gabor Tarkanyi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Neurology Neutrophils 030204 cardiovascular system & hematology lcsh:RC346-429 Pathogenesis Leukocyte Count 03 medical and health sciences 0302 clinical medicine Neuroinflammation White blood cell Internal medicine Leukocytes medicine Humans Clinical significance lcsh:Neurology. Diseases of the nervous system Aged Retrospective Studies Computed tomography angiography Aged 80 and over Inflammation Ischemic stroke medicine.diagnostic_test business.industry Confounding General Medicine Middle Aged Collateral circulation Peripheral Cerebrovascular Disorders Cross-Sectional Studies medicine.anatomical_structure Cardiology Female Neurology (clinical) business Large vessel occlusion 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Neurology BMC Neurology, Vol 20, Iss 1, Pp 1-8 (2020) |
| ISSN: | 1471-2377 |
| DOI: | 10.1186/s12883-020-02017-3 |
| Popis: | Background Neuroinflammation plays an important role in the pathogenesis of acute ischemic stroke (AIS) and peripheral leukocyte counts have proved to be independent predictors of stroke severity and outcomes. Clinical significance of large vessel occlusion (LVO) in AIS is increasing, as these patients are potential candidates for endovascular thrombectomy and likely to have worse outcomes if not treated urgently. The aim of our study was to assess the relationship between on admission leukocyte counts and the presence of LVO in the early phase of AIS. Methods We have conducted a cross-sectional, observational study based on a registry of consecutive AIS patients admitted up to 4.5 h after stroke onset. Blood samples were taken at admission and leukocyte counts were measured immediately. The presence of LVO was verified based on the computed tomography angiography scan on admission. Results Total white blood cell (WBC) and neutrophil counts were significantly higher in patients with LVO than those without LVO (P 9/L increase, 95% CI: 1.209 to 1.632) and neutrophil counts (adjusted OR: 1.344 per 1 × 109/L increase, 95% CI: 1.155 to 1.564) were found to have the strongest associations with the presence of LVO. Total WBC and neutrophil counts had moderate ability to discriminate an LVO in AIS (AUC: 0.667 and 0.655 respectively). No differences were recorded in leukocyte counts according to the size of the occluded vessel and the status of collateral circulation in the anterior vascular territory. However, total WBC and neutrophil counts tended to be higher in patients with LVO in the posterior circulation (p = 0.005 and 0.010 respectively). Conclusion Higher admission total WBC and neutrophil counts are strongly associated with the presence of LVO and has moderate ability to discriminate an LVO in AIS. Detailed evaluation of stroke-evoked inflammatory mechanisms and changes according to the presence of LVO demands further investigation. |
| Databáze: | OpenAIRE |
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