title: Oxfordshire Community Stroke Project classification but not NIHSS predicts symptomatic intracerebral hemorrhage following thrombolysis.
abstract: BACKGROUND
  The Oxfordshire Community Stroke Project (OCSP) classification is a simple tool to categorize clinical stroke syndromes. We compared the outcomes of stroke patients after intravenous thrombolysis stratified by the baseline National Institutes of Health Stroke Scale (NIHSS) score or by the OCSP classification.
  
  
  METHODS
  We assessed the safety of thrombolysis in consecutive stroke patients who received intravenous thrombolysis within 3h after onset. The patients were grouped by the NIHSS score into mild to moderate stroke (≤ 20) and severe stroke (>20), and also by the OCSP classification as having total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), posterior circulation infarcts (POCI), or lacunar infarcts (LACI). Symptomatic intracerebral hemorrhage (SICH) was used as the primary outcome.
  
  
  RESULTS
  Of the 145 patients included in the study, 45 had a baseline NIHSS score>20. Their stroke syndromes were as follows: 78 with TACI, 29 with PACI, 16 with POCI, and 22 with LACI. The proportion of SICH was comparable between patients with high or low NIHSS score (11.1% vs. 9.0%, P=0.690). The chance of SICH was highest in patients with TACI (15.4%), followed by LACI (4.5%), PACI (3.4%), and POCI (0%). After adjustment for age, baseline glucose, and use of antiplatelet agents before admission, SICH was significantly increased in patients with TACI relative to those with non-TACI (odds ratio 5.92; 95% confidence interval 1.24-28.33, P=0.026).
  
  
  CONCLUSIONS
  The OCSP clinical classification may help clinicians evaluate the risk of SICH following intravenous thrombolysis.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
authors.forename: Chi-Shun
authors.initials: CS
authors.lastname: Wu
authors.forename: Yung-Chu
authors.initials: YC
authors.lastname: Hsu
authors.forename: Mei-Chiun
authors.initials: MC
authors.lastname: Tseng
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Chen
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000145:classification; D020244:Infarction, Middle Cerebral Artery / Q000145:classification; D020762:Infarction, Posterior Cerebral Artery / Q000145:classification; D007275:Injections, Intravenous; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D059906:Neuroimaging; D061214:Patient Safety; D020521:Stroke / Q000145:classification* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D005343:Fibrinolytic Agents