A Risk Score to Predict Intracranial Hemorrhage After Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke

Background Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited. Methods Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each...

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Bibliographic Details
Published inJournal of stroke and cerebrovascular diseases Vol. 17; no. 6; pp. 331 - 333
Main Authors Cucchiara, Brett, MD, Tanne, David, MD, Levine, Steven R., MD, Demchuk, Andrew M., MD, Kasner, Scott, MD
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.11.2008
Subjects
acute ischemic stroke
Age Factors
Blood Coagulation Disorders
Brain Ischemia - drug therapy
Cardiovascular
Cerebral Angiography
Cerebral Arteries - diagnostic imaging
Cerebral Arteries - drug effects
Cerebral Arteries - physiopathology
Cerebral Hemorrhage - chemically induced
Cerebral Hemorrhage - epidemiology
Fibrinolytic Agents - adverse effects
Humans
Hyperglycemia - epidemiology
Intracerebral hemorrhage
Neurology
Patient Selection
Platelet Count
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment - methods
Risk Factors
risk scores
Stroke - drug therapy
thrombolysis
Tissue Plasminogen Activator - adverse effects
thrombolysis
risk scores
acute ischemic stroke
Intracerebral hemorrhage
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Summary:Background Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited. Methods Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each of 4 variables: age older than 60 years, baseline National Institutes of Health Stroke Scale score greater than 10, glucose greater than 8.325 mmol/L, and platelet count less than 150,000/mm3. Results Rate of any ICH increased with higher scores: 0 points, 2.6%; 1 point, 9.7%; 2 points, 15.1%; and greater than or equal to 3 points, 37.9%. The model had reasonable discriminatory capability (C-statistic 0.69). A similar pattern was seen with symptomatic and asymptomatic ICH separately, and with radiographically defined parenchymal hemorrhage. Conclusion A simple risk score may be useful for predicting postthrombolysis ICH.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2008.03.012