Admission Leukocytosis in Intracerebral Hemorrhage: Associated Factors and Prognostic Implications

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. 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 (GCS(0)) 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. 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 GCS(0). Leukocyte count showed a strong association with IVH (p = 0.01) and with decreasing GCS(0) (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. 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 GCS(0.) Prospective studies are needed to confirm these findings.