title: Monocyte Count and 30-Day Case Fatality in Intracerebral Hemorrhage.
abstract: OBJECTIVE
  Monocytes may contribute to secondary injury after intracerebral hemorrhage (ICH). We tested the association of absolute monocyte count with 30-day ICH case fatality in a multiethnic cohort.
  
  
  METHODS
  Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective, multicenter, case-control study of ICH among white, black, and Hispanic patients. In 240 adults with nontraumatic ICH within 24 hours of symptom onset, we evaluated the influence of ICH score and complete blood count components on 30-day case fatality using generalized linear models.
  
  
  RESULTS
  Mean age was 62.8 years (SD, 14 years); 61.7% were men, 33.3% black, and 29.6% Hispanic. Median ICH volume was 9.9 mL (interquartile range, 4.4-26.7). After adjusting for patient age and initial hemoglobin, higher total white blood cell count (P=0.0011), driven by higher absolute neutrophil count (P=0.002), was associated with larger ICH volume, whereas absolute monocyte count was not (P=0.15). After adjusting for age, Glasgow Coma Scale, ICH volume, location, and the presence or absence of intraventricular hemorrhage, baseline absolute monocyte count was independently associated with higher 30-day case-fatality (odds ratio, 5.39; 95% confidence interval, 1.87-15.49; P=0.0018), whereas absolute neutrophil count (odds ratio, 1.04; 0.46-2.32; P=0.93) and white blood cell count (odds ratio, 1.62; 0.58-4.54; P=0.36) were not.
  
  
  CONCLUSIONS
  These data support an independent association between higher admission absolute monocyte count and 30-day case-fatality in ICH. Inquiry into monocyte-mediated pathways of inflammation and apoptosis may elucidate the basis for the observed association and may be targets for ICH neuroprotection.
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Kyle B
authors.initials: KB
authors.lastname: Walsh
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Padmini
authors.initials: P
authors.lastname: Sekar
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Carl D
authors.initials: CD
authors.lastname: Langefeld
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Moomaw
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Michael L
authors.initials: ML
authors.lastname: James
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Osborne
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Sheth
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Woo
authors.affiliation: From the Department of Emergency Medicine (K.B.W., O.A.) and Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati (UC), OH; Department of Biostatistics, Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L.); Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E., A.K.B.); Departments of Anesthesiology and Neurology, Duke University, Durham, NC (M.L.J.); Department of Neurology, Yale University, New Haven, CT (K.N.S.); and UC Neuroscience Institute, OH (D.W., O.A.). Opeolu.Adeoye@uc.edu.
authors.forename: Opeolu
authors.initials: O
authors.lastname: Adeoye
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000379:methods; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors
keywords: Glasgow Coma Scale; cerebral hemorrhage; inflammation; monocytes; odds ratio