The Prevalence of Admission Leukocytosis and Systemic Inflammatory Response Syndrome (SIRS) in Intracerebral hemorrhage (ICH) Patients and Its Association with Primary Infection. (P3.103)

Background/Objective: In intracerebral hemorrhage (ICH) patients, the significance of leukocytosis on admission is unknown. Theories range from primary infection to acute inflammatory response. The aim of this study was to determine the prevalence of admission leukocytosis and systemic inflammatory response syndrome (SIRS) in ICH patients and its association with primary infection. Methods: We retrospectively reviewed the records of 213 consecutive ICH patients admitted to a single tertiary care center from October 2011 through January 2014. Thirty-four were excluded based on inadequate data or withdrawal of care within 6 hours of admission. Patients with admission leukocytosis (leukocytes 蠅 12.0 within the first 24 hours of admission [WBCp24]) were identified. We collected patients’ vital signs for identification of SIRS: peak/trough temperature, peak heart rate, and peak respiratory rate within the first 24 hours of admission. Microbiological data within the first 48 hours of admission and final body-fluid cultures within the first week of admission (Cx7) were recorded. Results:Of the 179 ICH patients, 46 (34[percnt]) presented with WBCp24. Mean WBCp24 was 15 ± 3.542. Ninety-one percent (42/46) met the criteria for SIRS. In 12 (26[percnt]) patients, no cultures sent (of which only 1 did not meet SIRS criteria). Only 13/34 patients (38[percnt]) had positive Cx7. Conclusions:Less than half of ICH patients with WBCp24 have positive Cx7. This is despite the over-whelming majority meeting SIRS criteria. WBCp24 may therefore be more often an indicative of acute inflammatory response to ICH than primary infection. Large-scale studies are needed to determine the impact of SIRS and leukocytosis on outcome in ICH patients. Disclosure: Dr. Hafeez has nothing to disclose. Dr. Zha has nothing to disclose. Dr. Grose has nothing to disclose. Dr. Mutgi has nothing to disclose. Dr. Behrouz has nothing to disclose.