Abstract Details

Title Admission Leukocyte Levels Differ According to Stroke Etiology in Patients with Neurological Deterioration Following Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 037

Objective

Background BACKGROUND: Leukocyte infiltration of the penumbra is thought to potentiate ND by promoting excitotoxic cell death. Elevated admission leukocyte levels predict ND and are associated with poor patient outcomes. However, little is known about whether admission leukocyte levels differ according to stroke etiology in ND patients.

Design/Methods DESIGN/METHODS: AIS patients presenting to our center within 48hrs of symptom onset between 07/2008 and 12/2010 were retrospectively identified by chart review and screened for ND (increase in National Institutes of Health Stroke Scale score ?2 within a 24hr period). Patients were excluded for steroid use one month prior to hospitalization and infection within 48hrs of admission. Stroke etiologies were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Admission leukocyte counts from routine blood draws were compared across stroke etiologies using Wilcoxon rank sum and Kruskal-Wallis test.

Results RESULTS: Ninety-two of the 295 (33%) patients screened had ND (median age 64, 57.6% male, 65.4% black). Among ND patients, there were significant differences in mean admission total leukocyte and neutrophil levels according to stroke etiology (p=0.023; p=0.001). However, we found that leukocyte and neutrophil levels did not differ in ND patients compared to non-ND patients for their respective stroke etiologies. Neutrophil levels in patients with cardioembolic stroke tended to be increased in ND patients compared to non-ND patients.

Conclusions CONCLUSIONS: At our center, admission leukocyte levels vary according to stroke etiology in ND patients, but there are no differences compared to non-ND patients for the same etiology. Since methods differ on investigating the role of leukocytosis and ND, further research is needed to elucidate ND risk-factors.

Authors/Disclosures
Andre Kumar PRESENTER	No disclosure on file
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Darcy Krueger, MD (Cincinnati Children'S Hospital Medical Center)	Dr. Krueger has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NobelPharma USA. Dr. Krueger has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for RegenxBio. Dr. Krueger has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis Pharmaceuticals. Dr. Krueger has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Greenwich Biosciences. The institution of Dr. Krueger has received research support from Greenwich Bioscience. The institution of Dr. Krueger has received research support from Marinus Pharmaceuticals. The institution of Dr. Krueger has received research support from National Institutes of Health. The institution of Dr. Krueger has received research support from Food and Drug Administration. The institution of Dr. Krueger has received research support from TSC Alliance.
Michael Gillette	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file

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