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 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/mm(3).


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.


CONCLUSIONS
A simple risk score may be useful for predicting postthrombolysis ICH.
Cucchiara
Brett
B
Department of Neurology, University of Pennsylvania Medical Center, Philadelphia 19104, USA. cucchiar@mail.med.upenn.edu
Tanne
David
D
Levine
Steven R
SR
Demchuk
Andrew M
AM
Kasner
Scott
S
D000367:Age Factors; D001778:Blood Coagulation Disorders; D002545:Brain Ischemia / Q000188:drug therapy*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D018579:Patient Selection; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator