Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients

Objective: In the present study, we sought to determine the predictive value of white blood cell (WBC) count measured on admission for in-hospital death in acute stroke patients. Methods: WBC count was measured automatically in 400 consecutive acute stroke patients (67.5 +/- 12.9 years old; 226 female) on admission to hospital. Patients included into the study had symptoms starting less than 12 h prior to hospitalization and no known causes of inflammation. Logistic regression adjusted for age, gender, the presence of diabetes, hypertension, atrial fibrillation, previous stroke and ischemic heart disease was used for the calculation of odds ratio (OR) with 95% confidence interval (CI) for in-hospital mortality. Results: Stroke patients with WBC counts in the third tertile (over 9.7 x 10(3) muL(-1)) had more than eight times (OR: 8.26; 95% Cl: 3.95-17.25; P < 0.0001) increased risk of in-hospital mortality as compared with the rest of the patients. The WBC count increment of every 1000 cell/muL was associated with OR for in-hospital death of 1.27 (95% Cl: 1.17-1.39; P < 0.0001). There was also a significant correlation between patients' WBC count and their clinical condition and degree of disability at the time of admission to hospital. Conclusion: An increased WBC count within the first 12 h of onset of an ischemic stroke is a strong prognostic factor for in-hospital mortality. (C) 2004 Elsevier B.V. All rights reserved.