Leukocyte count predicts outcome after ischemic stroke: the Northern Manhattan Stroke Study.
Leukocyte count predicts outcome after ischemic stroke: the Northern Manhattan Stroke Study.
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DOI：
10.1016/j.jstrokecerebrovasdis.2004.07.004
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发表时间：
2004-09-01
期刊：
影响因子：
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通讯作者：
Sacco, Ralph L
中科院分区：
文献类型：
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作者：
Elkind, Mitchell S V;Cheng, Jianfeng;Sacco, Ralph L
白细胞计数预测心血管疾病的发生，但关于白细胞计数与缺血性卒中后预后的关系的数据很少。我们假设发生缺血性脑卒中时的白细胞计数与预后有关。首次缺血性卒中患者随访5年，观察复发性卒中、心肌梗死（MI）或死亡的发生情况。构建Cox比例风险模型，在调整其他危险因素后，估计白细胞计数对结局影响的风险比和95%置信区间（ci）。对缺血性脑卒中患者（n = 655）进行评估（平均年龄69.7±12.7岁，45%为男性，51%为西班牙裔，28%为黑人，19%为白人）。70%的样本是在中风后24小时内抽取的。平均白细胞计数为9.1±4.7 × 10(9)/L。在调整了年龄、性别、种族/民族、其他危险因素和中风严重程度后，白细胞计数是30天卒中复发、心肌梗死或死亡风险的重要独立预测因子（白细胞计数每单位增加的校正危险比为1.07；95% CI为1.00至1.13）。白细胞计数也是5年内预后事件的重要独立预测因子（白细胞计数每单位增加的校正风险比为1.04；95% CI为1.00至1.07）。我们的研究结果表明，缺血性卒中时白细胞计数升高可预测未来卒中复发、心肌梗死或死亡。急性感染并发症的中风或潜在的炎症可以解释这种关联。
Leukocyte counts predict incident cardiovascular disease, but little data are available on the relationship of leukocyte count to outcome after ischemic stroke. We hypothesized that leukocyte count at the time of incident ischemic stroke is associated with prognosis. Patients with first ischemic stroke were prospectively followed for 5 years for the occurrence of recurrent stroke, myocardial infarction (MI), or death. Cox proportional hazard models were constructed to estimate hazard ratios and 95% confidence intervals (CIs) for the effect of leukocyte count on outcomes after adjusting for other risk factors. Ischemic stroke patients (n = 655) were evaluated (mean age, 69.7 +/- 12.7 years; 45% men; 51% Hispanic, 28% black, and 19% white). Seventy percent of samples were drawn within 24 hours of stroke. Mean leukocyte count was 9.1 +/- 4.7 x 10(9)/L. Leukocyte count was a significant independent predictor of the 30-day risk of recurrent stroke, MI, or death after adjusting for age, sex, race/ethnicity, other risk factors, and stroke severity (adjusted hazard ratio per unit increase in leukocyte count, 1.07; 95% CI, 1.00 to 1.13). Leukocyte count was also a significant independent predictor of outcome events over 5 years (adjusted hazard ratio per unit increase in leukocyte count, 1.04; 95% CI, 1.00 to 1.07). Our findings indicate that elevated leukocyte count at the time of ischemic stroke predicts future recurrent stroke, MI, or death. Acute infectious complications of stroke or underlying inflammation could account for this association.