Association between white blood cells and ultra-early hematoma growth in patients with spontaneous intracerebral hemorrhage.

BACKGROUND: Ultra-early inflammatory reaction after spontaneous intracerebral hemorrhage (sICH) plays an important role in the coagulation process and is closely related to early hematoma expansion. However, the relationship between ultra-early hematoma growth (uHG) and ultra-early inflammatory reaction remains unknown.

OBJECTIVE: To evaluate the association between ultra-early inflammatory indicators and uHG in patients with sICH.

METHODS: We retrospectively included 225 patients with acute sICH who were divided into the uHG ≤4.7 ml/h group and the uHG >4.7 ml/h group, respectively. The uHG was defined as hematoma volume (milliliter) at the primary computed tomography (CT) scan divided by time (hour) from onset to the performance of primary CT within 6 h after onset. The white blood cells (WBC), blood hypersensitive C-reactive protein, National Institutes of Health Stroke Scale (NIHSS) score and other related baseline data were collected and compared between the two groups. The multivariate regression analysis and receiver operating characteristic (ROC) curve were used to evaluate the independent risk factors for uHG >4.7 ml/h.

RESULTS: NIHSS score and WBC were independent risk factors for uHG in patients with acute sICH (OR 1.188, 95% CI : 1.111-1.271, p  < 0.001; OR 1.151, 95% CI : 1.018-1.300, p  = 0.024; respectively). The area under curve of ROC for WBC and NIHSS score was 0.658 and 0.754, respectively (all p  < 0.001), while the WBC combined with NIHSS score was 0.773 ( p  < 0.001).

CONCLUSION: WBC count within 6h after onset might be an independent risk factor for the increase of uHG in patients with sICH.