Peripheral leukocyte counts and outcomes after intracerebral hemorrhage.
Peripheral leukocyte counts and outcomes after intracerebral hemorrhage.
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DOI：
10.1186/1742-2094-8-160
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发表时间：
2011-11-16
影响因子：
9.3
通讯作者：
McCullough LD
中科院分区：
文献类型：
--
作者：
Agnihotri S;Czap A;Staff I;Fortunato G;McCullough LD
脑出血（ICH）是一种破坏性疾病，其30天死亡率约为45%。只有20%的幸存者在6个月时恢复独立功能。炎症在ICH病理生理学中的作用越来越被认识。几项临床研究已经证明了炎症标志物与ICH后结局之间的相关性;然而，之前尚未评价血清生物标志物与幸存者功能结局之间的关系。通过外周血白细胞计数的变化来检测炎症反应的激活，并确定ICH后死亡率和功能结局的评估。纳入了2005年1月至2010年4月期间在三级医疗中心住院的自发性ICH患者。白细胞计数的变化测量为前72小时内最大白细胞计数与入院时白细胞计数之间的差异。死亡率是主要结局。次要结局是1年时的死亡率、出院处置和3个月时与入院前MBI相比的改良Barthel指数（MBI）。共纳入病例423例。住院病死率为30.4%。白细胞计数的变化预测更差的出院处置（OR = 1.258，p = 0.009）。白细胞计数的变化也与3个月时MBI的下降显著相关。即使在所有有感染证据的患者被移除后，这些关系仍然存在。入院后72小时内白细胞计数的较大变化预示着ICH后短期和长期功能结局均较差。
Intracerebral hemorrhage (ICH) is a devastating disease that carries a 30 day mortality of approximately 45%. Only 20% of survivors return to independent function at 6 months. The role of inflammation in the pathophysiology of ICH is increasingly recognized. Several clinical studies have demonstrated an association between inflammatory markers and outcomes after ICH; however the relationship between serum biomarkers and functional outcomes amongst survivors has not been previously evaluated. Activation of the inflammatory response as measured by change in peripheral leukocyte count was examined and assessment of mortality and functional outcomes after ICH was determined. Patients with spontaneous ICH admitted to a tertiary care center between January 2005 and April 2010 were included. The change in leukocyte count was measured as the difference between the maximum leukocyte count in the first 72 hours and the leukocyte count on admission. Mortality was the primary outcome. Secondary outcomes were mortality at 1 year, discharge disposition and the modified Barthel index (MBI) at 3 months compared to pre-admission MBI. 423 cases were included. The in-hospital mortality was 30.4%. The change in leukocyte count predicted worse discharge disposition (OR = 1.258, p = 0.009). The change in leukocyte count was also significantly correlated with a decline in the MBI at 3 months. These relationships remained even after removal of all patients with evidence of infection. Greater changes in leukocyte count over the first 72 hours after admission predicted both worse short term and long term functional outcomes after ICH.
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影响因子：
4.7
作者：
Loftspring, Matthew C.;Hansen, Craig;Clark, Joseph F.
通讯作者：
Clark, Joseph F.
影响因子：
48
作者：
van Asch, Charlotte J. J.;Luitse, Merel J. A.;Klijn, Catharina J. M.
通讯作者：
Klijn, Catharina J. M.
影响因子：
168.9
作者：
Qureshi, Adnan I.;Mendelow, A. David;Hanley, Daniel F.
通讯作者：
Hanley, Daniel F.
DOI：
10.1016/s1052-3057(99)80032-9
发表时间：
1999-01-01
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
Mackenzie, J M;Clayton, J A
通讯作者：
Clayton, J A
影响因子：
8.3
作者：
SUZUKI, S;KELLEY, RE;DUNCAN, RC
通讯作者：
DUNCAN, RC