The diagnostic value of complete blood count parameters in patients with subarachnoid hemorrhage

Turgay Yılmaz Kilic; Ersin Aksay; Ozge Duman Atilla; Savas Sezik; Mahmut Camlar

doi:10.1016/j.tjem.2017.07.003

Turgay Yılmaz Kilic¹, Ersin Aksay², Ozge Duman Atilla¹, Savas Sezik¹, Mahmut Camlar³

¹Izmir Tepecik Research and Educational Hospital, Department of Emergency Medicine, Izmir, Turkey
²Dokuz Eylul University Hospital, Department of Emergency Medicine, Izmir, Turkey
³Izmir Tepecik Research and Educational Hospital, Department of Neurosurgery, Izmir, Turkey

Keywords: Complete blood count; Subarachnoid hemorrhage; Emergency medicine

Abstract

Objectives: Diagnosis of subarachnoid hemorrhage (SAH) in patients presenting with headache is challenging and there has been any biomarker studied for excluding of SAH in those patients. We aim to determine the sensitivity of leukocytosis or left shift to exclude the diagnosis of SAH in ED patients presenting with headache.

Method: Adult patients with headache who received a computed tomography (CT) with the diagnosis of SAH and had a complete blood count (CBC) represent the case group, headache patients with normal CT and had a CBC represent the control group. The white blood cell (WBC) count and percentage of polymorphonuclear cells (PMNs%) taken during admission and within the first 6 and 12 h of admission were recorded.

Results: A hundred ninety seven patients with SAH and 197 patients without SAH were enrolled in to study. Sensitivity, specificity, NPV and PPV of leukocytosis or increase in PMNs% (left shift) in the diagnosis of SAH was 89.8% (84.5–93.5, 95% CI), 46.7% (39.6–53.9, 95% CI), 82.1% (73.5–88.4, 95% CI) and 62.8% (56.8–68.4, 95% CI) respectively on initial emergency department (ED) admission.

Conclusion: CBC should be considered as a noninvasive test for the exclusion of SAH in ED patients with 6 h observation.