# Evaluation of Hemoglobin and Eosinophil Count in Patients Receiving Thrombolytic Treatment

## TL;DR

This study explores how blood cell levels, including hemoglobin and eosinophils, relate to outcomes in stroke patients receiving clot-busting treatment.

## Contribution

The study identifies hemoglobin and eosinophil levels as significant predictors of mortality and stroke severity in thrombolytic-treated patients.

## Key findings

- Lower hemoglobin levels are associated with higher mortality in stroke patients.
- Eosinophil count negatively correlates with stroke severity and symptom duration.
- Hemoglobin is a significant predictor of mortality in a logistic regression model.

## Abstract

Background and aim

Stroke ranks among the primary contributors to disability and mortality on a global scale. Recent advances in ischemic stroke pathophysiology emphasize the significant role of the immune system in both stroke-related damage and neuroprotection. This article investigates the relationship between hemoglobin level and white blood cell count.

Materials and methods

From January 1, 2019, to April 1, 2022, all patients aged 18 years and over who were diagnosed with acute ischemic stroke in the emergency department of Kanuni Sultan Süleyman Training and Research Hospital and treated with intravenous recombinant tissue plasminogen activator (r-tPA) within 4.5 hours of stroke onset were included in this cross-sectional retrospective study. Gender, age, onset of symptoms, complaints, National Institutes of Health Stroke Scale (NIHSS) score, stroke-affected area, as well as leukocyte, neutrophil, platelet, eosinophil, lymphocyte, and hemoglobin levels were recorded and compared between mortality and survivor groups.

Results

A total of 61 people, including 33 men and 28 women, were included in the study. Four patients died during follow-ups. The mean duration of symptoms upon admission was 86.23 ± 56.37 minutes. The mean NIHSS score of patients was found to be 9.16 ± 3.88 (minimum: 4, maximum: 18). There was a statistically significant positive correlation between age and symptom duration (p < 0.002, r: 0.391). A statistically significant negative correlation was found between eosinophil count and NIHSS score (p < 0.012, r: -0.321) and between eosinophil count and symptom duration (p < 0.042, r: -0.261). There was a negative correlation between hemoglobin levels and mortality (p < 0.013, r: -0.318). A statistically significant negative correlation was observed between the eosinophil-to-neutrophil ratio (ENR) and NIHSS score (p < 0.017, r: -0.305) as well as between ENR and symptom duration (p < 0.034, r: -0.271). Hemoglobin is a significant predictor of mortality in the logistic regression model (p < 0.05, CI: 0.253-0.942). For each one-unit increase in hemoglobin, the odds of mortality decrease by a factor of 0.488.

Conclusion

Certain blood cell types (neutrophils, eosinophils, and lymphocytes) play an active role in determining stroke prognosis. A detailed explanation of the role of leukocyte types lays the foundation for “immunomodulation,” which could be a promising novel treatment modality for future stroke patients.