Abstract
Symptomatic intracerebral haemorrhage following thrombolysis for
ischaemic stroke causes significant morbidity and mortality. This study assessed
which of four risk scores (SEDAN, HAT, GRASPS and SITS) best predicts
symptomatic intracerebral haemorrhage.
Methods: Data from 431 patients treated at Aberdeen Royal Infirmary (2003–
2013) were extracted from a thrombolysis database. Score performance was
compared using area under the curve.
Results: Any intracerebral haemorrhage occurred in 12% of patients (53/413);
11% fulfilling the SITS-MOST symptomatic intracerebral haemorrhage definition
(6/53), 34% the ECASS II definition (18/53), and 43% the National Institute of
Neurological Disorder and Stroke definition (23/53). Stroke severity, as defined
by the National Institutes of Health Stroke Scale, significantly improved after 24
hours in patients without intracerebral haemorrhage, but not in those with.
Significant symptomatic intracerebral haemorrhage predictors were age, glucose,
stroke severity, hyperdense middle cerebral artery on CT scan, ASPECTS score
and anti-platelet therapy. The haemorrhage after thrombolysis score performed
best at predicting symptomatic intracerebral haemorrhage (area under the curve
0.67–0.78, p < 0.001).
Conclusion: The haemorrhage after thrombolysis score uses the least variables
and has the best predictive value for symptomatic intracerebral haemorrhage.
Using predictive scores for clinical decision making depends on estimation of
overall benefits as well as risk.
Original language | English |
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Pages (from-to) | 127-132 |
Number of pages | 6 |
Journal | Journal of the Royal College of Physicians of Edinburgh |
Volume | 45 |
Issue number | 2 |
DOIs | |
Publication status | Published - 2015 |
Keywords
- outcome prediction
- predictive risk scores
- stroke thrombolysis
- symptomatic intracerebral haemorrhage