title: Admission Leukocytosis in Intracerebral Hemorrhage: Associated Factors and Prognostic Implications.
abstract: OBJECTIVE
  Leukocytosis is a reaction that is usually, but not always, associated with an infectious process. There is very little data on the significance of admission leukocytosis (AL) in patients with intracerebral hemorrhage (ICH). The purpose of this study was to investigate the associated clinical and radiologic findings and prognostic significance of AL in patients with ICH.
  
  
  METHODS
  We retrospectively reviewed the records of consecutive ICH patients admitted over a 2-year period. Key data we collected included ICH size, location, intraventricular hemorrhage (IVH), age, admission Glasgow Coma Scale (GCS0) score, peak leukocyte count and temperature in the first 24 h of hospitalization, and outcomes on discharge. Severity of IVH was calculated using the Graeb Scale. Logistic regression was performed to determine association of variables.
  
  
  RESULTS
  In 128 consecutive ICH patients, AL was present in 41.4 %. AL was significantly associated with presence (OR 2.28, 95 % CI 1.11-4.68; p = 0.024), but not severity of IVH and with admission GCS0. Leukocyte count showed a strong association with IVH (p = 0.01) and with decreasing GCS0 (p = 0.007). There was no correlation between AL and poor outcome at discharge. There was also no evidence of infection in any patient with AL.
  
  
  CONCLUSIONS
  AL in ICH patients is often non-infectious, strongly associated with the presence of IVH, but not specifically an ominous indicator for outcome. Leukocyte count has an inverse relationship with GCS0. Prospective studies are needed to confirm these findings.
authors.affiliation: Division of Cerebrovascular Diseases and Neurosciences Critical Care, Department of Neurology, The Ohio State University College of Medicine, 333 West 10th Avenue, Suite 3170, Columbus, OH, USA. Reza.Behrouz@osumc.edu.
authors.forename: Réza
authors.initials: R
authors.lastname: Behrouz
authors.affiliation: Division of Cerebrovascular Diseases and Neurosciences Critical Care, Department of Neurology, The Ohio State University College of Medicine, 333 West 10th Avenue, Suite 3170, Columbus, OH, USA.
authors.forename: Shaheryar
authors.initials: S
authors.lastname: Hafeez
authors.affiliation: Neuroscience Regional Development and Clinical Integration, Ohio Health, Columbus, OH, USA.
authors.forename: Chad M
authors.initials: CM
authors.lastname: Miller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Intracerebral hemorrhage; Intraventricular hemorrhage; Leukocytosis; Outcomes