Peripheral Monocytosis at Admission to Predict Cerebral Infarct and Poor Functional Outcomes in Subarachnoid Hemorrhage Patients.

Objective Increasing evidence points monocytes role to be larger than thought in developing cerebral infarction (CI) after SAH. However, there is no clinical evidence of the relationship between peripheral monocytes and CI, and clinical outcomes. Therefore, we determine whether an increase in monocytes in the acute phase is useful to predict CI and functional outcomes in SAH patients. Methods 204 patients with SAH diagnosis were included. We collected patient-related factors, comorbidities, Hunt-Hess grade, modified Fisher grade, treatment, DCI, CI, aneurysm characteristics and peripheral monocytes from vein blood at admission. Poor outcomes were defined as mRS ≥ 3. Results 50 (24.5%) patients had CI before discharge. In a multivariate model, increased monocytes at admission was significantly associated with CI after adjusting for IV-V Hunt-Hess grade and DCI (OR: 3.193, 95% CI: 1.069-9.532, p=.037). In ROC analysis, monocytes count of 0.60 was identified as the best cutoff value to discriminate the development of CI (area under the curve=0.622, p=.010; CI for monocytes Conclusions Increased peripheral monocytes at admission is a risk factor for developing CI after SAH. Moreover, short and long-term poor clinical outcomes were associated with higher monocyte count. Therefore, monocytes could be a convenient biomarker to prognosis unfavorable outcomes and a possible target for new therapeutic strategies.