Eosinopenia as a Predictive Factor of the Short-Term Risk of Mortality and Infection after Acute Cerebral Infarction

J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1307-12. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.007. Epub 2016 Mar 9.

Abstract

Background: Eosinopenia has been shown to be a prognostic factor in bacteremia, chronic obstructive pulmonary disease, and myocardial infarction, but studies focusing on cerebral infarction are lacking.

Methods: We conducted a retrospective study of 405 patients admitted to the Asahi General Hospital from June 2011 to September 2014 with a diagnosis of cerebral infarction within 24 hours after symptom onset. Differences in mortality, mortality associated with infection, and the prevalence of infection within 2 months of hospital admission were assessed between patients with and without eosinopenia at presentation.

Results: Patients with eosinopenia had a significantly higher mortality rate (hazard ratio (HR) 2.54, 95% confidence interval (CI) 1.17-5.21, P = .01), mortality associated with infection (HR 28.7, 95% CI 4.9-542.2, P <.0001), and an increased prevalence of infection (HR 1.83, 95% CI 1.12-2.89, P = .01) than patients without eosinopenia. Patients with neutrophilia and eosinopenia showed a significantly higher mortality rate than patients without neutrophilia (HR 3.15, 95% CI 1.40-6.92, P = .007), whereas patients with neutrophilia without eosinopenia showed no significant difference in mortality compared with patients without neutrophilia (HR 1.57, 95% CI .56-3.93, P = .37). Eosinopenia was a significant risk factor in 2-month mortality rate in multivariate analyses (HR 2.34, 95% CI 1.05-4.95, P = .04).

Conclusions: Eosinopenia is a novel predictive factor for complications after acute cerebral infarction. Stroke patients with eosinopenia should be monitored carefully for infection.

Keywords: Cerebral infarction; eosinopenia; infection; predictive factor.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Cerebral Infarction / blood
  • Cerebral Infarction / complications
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / mortality*
  • Chi-Square Distribution
  • Communicable Diseases / blood
  • Communicable Diseases / diagnosis
  • Communicable Diseases / mortality*
  • Eosinophils*
  • Female
  • Humans
  • Japan / epidemiology
  • Leukocyte Count
  • Leukocyte Disorders / blood
  • Leukocyte Disorders / diagnosis
  • Leukocyte Disorders / mortality*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors