Persistent leukocytosis-is this a persistent problem for patients with acute ischemic stroke?

Area of Science:

• Neurology
• Inflammation Research
• Stroke Medicine

Background:

• Leukocytosis indicates inflammation in acute ischemic stroke (AIS).
• Admission leukocytosis correlates with initial stroke severity.
• Differences between transient and persistent leukocytosis in non-infected AIS patients remain unclear.

Purpose of the Study:

• To determine the clinical significance of persistent versus transient leukocytosis in the early phase of AIS.
• To assess the association between persistent leukocytosis and patient outcomes.

Main Methods:

• Retrospective chart review of AIS patients with admission leukocytosis (WBC >11,000/μL) within 48 hours of symptom onset.
• Logistic regression used to evaluate persistent leukocytosis (at 48 hours) as a predictor of functional outcomes.
• Marginal effects calculated to estimate the probability of poor functional outcome.

Main Results:

• Of 49 patients with admission leukocytosis, 24 (49%) had persistent leukocytosis.
• Persistent leukocytosis correlated significantly with higher NIHSS scores (r=.306; P=.0044).
• Transient leukocytosis was associated with better functional outcomes (44% vs. 16%; P=.006).
• Persistent leukocytosis increased the probability of poor functional outcome by 16 percentage points after controlling for age and NIHSS.

Conclusions:

• Persistent leukocytosis is associated with increased baseline stroke severity (NIHSS scores).
• Persistent leukocytosis is linked to poor short-term functional outcomes in AIS patients, even without infection.
• Identifying persistent leukocytosis aids in prognostication and may identify candidates for anti-inflammatory therapies.