Evidence map›Paper›PMID 26362283›Full record

ArticleNeurology2015

Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes.

Ilaria Maestrini, Daniel Strbian, Sophie Gautier, Elena Haapaniemi, Solène Moulin, Tiina Sairanen, Nelly Dequatre-Ponchelle, Gerli Sibolt, Charlotte Cordonnier, Susanna Melkas and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 10 pooled it
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Ilaria MaestriniFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Daniel StrbianFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Sophie GautierFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Elena HaapaniemiFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Solène MoulinFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Tiina SairanenFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Nelly Dequatre-PonchelleFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Gerli SiboltFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Charlotte CordonnierFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Susanna MelkasFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Didier LeysFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland. didier.leys@univ-lille2.fr.
Turgut TatlisumakFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.
Régis BordetFrom the Departments of Neurology (I.M., S.G., S. Moulin, N.D.-P., C.C., D.L., R.B.) and Pharmacology (S. Moulin, N.D.-P., C.C., D.L.), INSERM U 1171, University of Lille, UDSL; CHU Lille (S.G., R.B.), France; "Sapienza" University of Rome (I.M.), Italy; and the Department of Neurology (D.S., E.H., T.S., G.S., S. Melkas, T.T.), Helsinki University Central Hospital, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether higher neutrophil counts before IV recombinant tissue plasminogen activator (rtPA) administration in ischemic stroke (IS) patients are associated with symptomatic intracerebral hemorrhages (sICH) and worse outcomes at 3 months.

methodsBlood samples for leukocyte, neutrophil, and lymphocyte counts were drawn before IV rtPA administration in IS patients included in the cohorts of Lille and Helsinki. The primary endpoint was sICH (European Cooperative Acute Stroke-II definition). Secondary endpoints were death and excellent (modified Rankin Scale [mRS] score 0-1 or equal to prestroke mRS) and good (mRS score 0-2 or equal to prestroke mRS) outcomes at 3 months.

resultsWe included 846 patients (median age 71 years; 50.8% men). The neutrophil count and neutrophil to lymphocyte ratio (NLR) were independently associated with the 4 endpoints: sICH (adjusted odds ratio [adjOR] for an increase of 1,000 neutrophils = 1.21 and adjOR 1.11, respectively), death (adjOR 1.16 and adjOR 1.08), and excellent (adjOR 0.87 and adjOR 0.85) and good (adjOR 0.86 and adjOR 0.91) outcomes. The total leukocyte count was not associated with any of the 4 endpoints. The best discriminating factor for sICH was NLR ≥4.80 (sensitivity 66.7%, specificity 71.3%, likelihood ratio 2.32). Patients with NLR ≥4.80 had a 3.71-fold increased risk for sICH (95% confidence interval adjOR: 1.97-6.98) compared to patients with NLR <4.80.

conclusionsHigher neutrophil counts and NLR are independently associated with sICH and worse outcome at 3 months. The identification of mediators of this effect could provide new targets for neuroprotection in patients treated by rtPA.

Indexed as

AgedAged, 80 and overBrain IschemiaCerebral HemorrhageCohort StudiesFemaleHumansMaleMiddle AgedNeutrophilsPredictive Value of TestsProspective StudiesRegistriesRisk FactorsThrombolytic TherapyTissue Plasminogen ActivatorTissue Plasminogen Activator

Identifiers

PMID26362283
PMCPMC4626239

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.