Predictive Values of White Blood Cell Count in Peripheral Blood at Admission on In-Hospital Complications and 90-Day Outcomes of Patients with Aneurysmal Subarachnoid Hemorrhage: Insights from the LongTEAM Registry

Runting Li; Yuanli Zhao; Xiaolin Chen; Qiang Hao

doi:10.2147/JIR.S386558

Predictive Values of White Blood Cell Count in Peripheral Blood at Admission on In-Hospital Complications and 90-Day Outcomes of Patients with Aneurysmal Subarachnoid Hemorrhage: Insights from the LongTEAM Registry

J Inflamm Res. 2022 Nov 28:15:6481-6494. doi: 10.2147/JIR.S386558. eCollection 2022.

Authors

Runting Li¹, Yuanli Zhao^{1

2

3

4}, Xiaolin Chen^{1

3

4}, Qiang Hao¹

Affiliations

¹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
² China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.
³ Stroke Center, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
⁴ Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China.

Abstract

Purpose: This study aimed to explore the relationship between white blood cells (WBCs) at admission and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Patients and methods: We analyzed data from patients with aSAH between January 2015 and September 2021 who were included in the LongTEAM (Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage) registry study. WBC is classified into four groups according to the quartile. We used the logistic model for in-hospital complications, mortality, modified Rankin scale (mRS) at discharge and 90 days to examine the relationship between WBC and clinical outcomes. We used WBC levels near odds ratio (OR) = 1 (Q1) in restricted cubic splines as the reference to evaluate whether there is a nonlinear relationship between WBC and clinical outcomes. Another Kaplan-Meier method was used to analyze the relationship between WBC levels and the risk of developing pneumonia.

Results: Of the 988 patients included, the results showed that compared with patients in the Q1 group, patients in the highest quartile (Q4) had an increased incidence of 90-day unfavorable outcomes after adjusting the confounders (adjusted OR = 1.81, 95% CI = 1.02-3.20, p = 0.042), which may be caused by the increased incidence and risk of pneumonia (adjusted OR = 2.06, 95% CI = 1.30-3.29, p = 0.002; adjusted hazard ratio [HR]=1.63, 95% CI = 1.13-2.36, p < 0.001). The restricted cubic spline indicated that the incidence of developing pneumonia and 90-day unfavorable outcomes rises with increasing WBC levels (p for nonlinear = 0.135 and 0.113).

Conclusion: Patients with higher WBC at admission were associated with an increased incidence of 90-day unfavorable outcomes, which might be related to pneumonia.

Keywords: aneurysmal subarachnoid hemorrhage; functional outcome; pneumonia; white blood cell.

Grants and funding

This study was supported by the National Key Research and Development Program of China (Grant Nos. 2021YFC2501101 and 2020YFC2004701), Beijing Municipal Administration of Hospitals Incubating Program, Beijing, China (Grant No. pX2020023), and the Natural Science Foundation of Beijing, China (Grant No. 7204253).