Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms

Pei-Sen Yao,Xue-Ling Xie,Huang-Cheng Shang-Guan,Shu-Fa Zheng,Guo-Rong Chen,Yuan-Xiang Lin,Jin-Zhen Gao,Zhang-Ya Lin,De-Zhi Kang

doi:10.1038/s41598-018-23934-x

Abstract

It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients’ demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus, aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed. In the multivariable analysis model, gender, Fisher grade, time to surgery and hydrocephalus were not relevant to poor outcome. However, Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were significantly associated with adverse outcome. The respective increased risks were 5.2- (OR 5.24, 95% CI 1.67–16.50, p = 0.005), 6.2-(OR 6.24, 95% CI 3.55–10.99, p < 0.001) and 10.9-fold (OR 10.93, 95% CI 5.98–19.97, p < 0.001). The study revealed that Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were independent risk factors for poor outcome of ruptured CA at 3 months. Higher leukocyte count is a convenient and useful marker to predict 3-month poor outcome for ruptured CA.

Highlights

It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not
The exclusion criteria were: (1) Ruptured CA were detected over 3 days; (2) The patients presented with herniation, or were associated with the other cerebrovascular diseases and brain tumor; (3) The patients were associated with fever, infection, inflammatory process, or received any medical treatment that might have an influence on the leukocyte count in peripheral blood
The univariate analysis indicated there were significant differences were detected in gender, Fisher grade, hydrocephalus, time to surgery, delayed ischemic neurological deficit (DIND), leukocyte count between favorable and poor groups (p < 0.05)

Summary

Introduction

It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were significantly associated with adverse outcome. The study revealed that Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were independent risk factors for poor outcome of ruptured CA at 3 months. It was reported that several risk factors (such as older age, poor Hunt & Hess grade, higher Fisher grade, hypertension, hydrocephalus, hyperglycemia, excess weight and time to surgery) could lead to and predict the poor outcome for ruptured CA2,3. In order to test the hypothesis that preoperative higher leukocyte count is associated with and predict the poor outcome at 3 months, we retrospectively analyzed the clinical data of a relatively large number of patients with ruptured CA treated with microsurgical clipping

Methods

Results

Conclusion