Thrombolysis in stroke patients with elevated inflammatory markers

• DOI: 10.1007/s00415-022-11173-0
• Publication Date: 2022-05-27T13:03:24Z
• Authors: Valerian L. Alter...; Lukas S. Enz; Gerli Sibolt; Christian Hametner; Stefania Nannoni; Mirjam R. Heldner; Jeffrey Stolp; Dejana R. Jovanovic; Andrea Zini; Alessandro Pezzini; Susanne Wegener; Carlo W. Cereda; George Ntaios; Silja Räty; Christoph Gumbinger; Miriam Heyse; Alexandros A. Pol...; Annaelle Zietz; Anna Schaufelbuehl; Davide Strambo; Giovanna Padlina; Nedelina Slavova; Marjaana Tiainen; Kati Valkonen; Twan J. van Velzen; Guido Bigliardi; Predrag Stanarcevic; Mauro Magoni; Andreas Luft; Yannick Bejot; Laura Vandelli; Visnja Padjen; Paul J. Nederkoorn; Marcel Arnold; Patrik Michel; Peter A. Ringleb; Sami Curtze; Stefan T. Engelter; Henrik Gensicke
• Keywords: Leukocytosis; Stroke; Leukopenia

Abstract 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 TRISP registry, we assessed association between WBC admission 3-month poor outcome (modified Rankin Scale 3–6), occurrence symptomatic intracranial hemorrhage (sICH; ECASS-II-criteria) IVT-treated patients. was used as continuous categorical variable distinguishing leukocytosis (WBC > 10 × 9 /l) leukopenia < 4 /l). We calculated unadjusted/ adjusted odds ratios 95% confidence intervals (OR [95% CI]) logistic regression models. a subgroup, analyzed combined elevated C-reactive protein (CRP mg/l) outcomes. Results Of 10,813 patients, 2527 had leukocytosis, 112 8174 normal WBC. Increasing (by 1 predicted 1.04[1.02–1.06]) but not sICH. Leukocytosis independently associated 1.48[1.29–1.69]) 1.60[1.35–1.89]) sICH 1.17[0.94–1.45]). Leukopenia did predict any outcome. CRP strongest 2.26[1.76–2.91]) 2.43[1.86–3.16]) when compared to CRP. Conclusion death. Bleeding complications after IVT were leukocytosis.