There may exist a combined effect of WBC count and blood glucose level on stroke outcomes based on the similar mechanisms. Stress and inflammatory response are the two main causative factors leading to higher WBC and high glucose associated with mortality and pneumonia after acute stroke. Several studies indicated that high WBC and high glucose level were not only associated with high risk of poor outcome and mortality but also pneumonia after stroke. Increased white blood cell (WBC) count and high glucose level are frequently found in patients with acute ischemic stroke (AIS). Moreover, the combination of WBC count and blood glucose level appeared to be a better predictor than WBC count or blood glucose alone. High WBC count combined with high blood glucose level at admission was independently associated with in-hospital mortality and pneumonia in AIS patients. The C-statistic for the combined WBC count and blood glucose was higher than WBC count or blood glucose alone for prediction of in-hospital mortality and pneumonia (all p < 0.01). The risk of pneumonia was significantly higher in patients with HWHG compared to those with NWNG (adjusted odds ratio 2.61 95% CI, 1.66–4.10 P trend < 0.001). HWHG was associated with a 2.22-fold increase in the risk of in-hospital mortality in comparison to NWNG (adjusted hazard ratio 2.22 95% confidence interval, 1.21–4.07 P trend = 0.003). Cox proportional hazard model and logistic regression model were used to estimate the combined effect of WBC count and blood glucose on all-cause in-hospital mortality and pneumonia in AIS patients. We divided patients into four groups according to their level of WBC count and blood glucose: NWNG (normal WBC count and normal glucose), NWHG (normal WBC count and higher glucose), HWNG (higher WBC count and normal glucose), and HWHG (higher WBC count and higher glucose). MethodsĪ total of 3124 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in the present study. We investigated the combined effect of high WBC count and high blood glucose level on hospital admission and in-hospital mortality and pneumonia in acute AIS patients.

High white blood cell (WBC) count and high blood glucose level are risk factors for mortality and pneumonia after acute ischemic stroke (AIS).

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