Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
Department of Neurosurgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Neurocrit Care. 2023 Oct;39(2):445-454. doi: 10.1007/s12028-023-01716-2. Epub 2023 Apr 10.
The association between white blood cell (WBC) counts and mortality in patients with intracerebral hemorrhage (ICH) has not been established. The aim of this study is to determine whether higher WBC is associated with mortality at 90 days.
A retrospective observational study was conducted at two medical hospitals in China. Baseline WBC count on admission served as the primary predictor variable. Longitudinal WBC counts within the first week after admission were collected to assess the effects of WBC trajectory and the median and maximum WBC counts on outcomes following ICH. Associations of WBC count with outcomes were evaluated in multivariable regression analyses.
We identified 3613 patients with ICH who met the inclusion criteria. After adjusting primary confounding variables, patients with increased WBC count had a significantly higher risk of 90-day mortality (p < 0.001 for trend). In the receiver operating characteristic analyses, the capacity for all-cause mortality prediction by WBC count on admission (area under the ROC curve (AUC) = 0.65) was superior to other important inflammatory markers, including neutrophil (AUC = 0.64) , lymphocyte (AUC = 0.57), albumin (AUC = 0.57), and platelet count (AUC = 0.53), p < 0.001 for WBC vs. neutrophil, and the median WBC count (AUC = 0.66) within the first week after admission was a better marker than admission WBC count (p = 0.02).
In patients with ICH, WBC count on admission was associated with all-cause mortality at 90 days. Additionally, the median and maximum WBC counts within the first week after admission showed better predictive ability for the 90-day mortality compared with the WBC count on admission.
白细胞 (WBC) 计数与脑出血 (ICH) 患者的死亡率之间的关系尚未确定。本研究旨在确定较高的 WBC 是否与 90 天的死亡率相关。
本研究为在中国的两家医院进行的回顾性观察性研究。入院时的基础 WBC 计数作为主要预测变量。在入院后第一周内收集纵向 WBC 计数，以评估 WBC 轨迹以及中位数和最大值对 ICH 后结果的影响。使用多变量回归分析评估 WBC 计数与结果的相关性。
我们确定了符合纳入标准的 3613 例 ICH 患者。在校正主要混杂变量后，WBC 计数增加的患者 90 天死亡率显著升高（趋势 p<0.001）。在接受者操作特征分析中，入院时 WBC 计数对全因死亡率的预测能力（ROC 曲线下面积 (AUC) = 0.65）优于其他重要的炎症标志物，包括中性粒细胞 (AUC = 0.64)、淋巴细胞 (AUC = 0.57)、白蛋白 (AUC = 0.57) 和血小板计数 (AUC = 0.53)，p<0.001，WBC 与中性粒细胞相比，入院后第一周内的中位数 WBC 计数（AUC = 0.66）是比入院时 WBC 计数更好的标志物（p=0.02）。
在 ICH 患者中，入院时的 WBC 计数与 90 天的全因死亡率相关。此外，入院后第一周内的中位数和最大值 WBC 计数对 90 天死亡率的预测能力优于入院时的 WBC 计数。
