title: Factors affecting the occurrence of symptomatic intracerebral haemorrhage after intravenous thrombolysis depending on the haemorrhage definition.
abstract: OBJECTIVE
  Symptomatic intracerebral haemorrhage (sICH) remains the most feared complication of systemic thrombolysis in patients with ischaemic stroke. The aim of the study was to analyze the impact of different factors on the occurrence of sICH, depending on definition used.
  
  
  METHODS
  We retrospectively evaluated the influence of several factors on the occurrence of sICH (according to definitions used in ECASS2, SITS-MOST and NINDS studies) in 200 patients treated with systemic thrombolysis from 2006 to 2011. Multivariate analysis of impact of individual variables on the occurrence of haemorrhagic transformation (HT) and parenchymal haemorrhage type 2 (PH2) were performed.
  
  
  RESULTS
  Haemorrhagic transformation occurred in 35 cases (17.5%). SICH was found in 10 cases according to ECASS2, in 7 cases according to SITS and in 13 cases according to NINDS. Older age was related to higher risk of sICH, regardless which definition was used (ECASS2: p = 0.014, SITS-MOST: p = 0.048, NINDS: p = 0.008), and female sex was related to higher risk of sICH according to NINDS and ECASS2 definition (p = 0.002 and p = 0.04, respectively). Blood glucose level and high NIHSS score (> 14 pts) were found as risk factor of sICH in ECASS2 definition (p = 0.044 and p = 0.03, respectively). In multivariate logistic regression higher NIHSS scores were associated with HT independent of age, gender and glucose level (p = 0.012). Multivariate analysis showed no impact of age, gender, severity of stroke and glucose level on presence of PH2.
  
  
  CONCLUSIONS
  Definition of sICH can determine variables that are related to a high risk of this complication. In our study most factors correlated with sICH using the ECASS2 definition.
authors.affiliation: dr Monika Śledzińska-Dźwigał, SPZZOZ Sandomierz, Schinzla 13, 27-600 Sandomierz, Poland, e-mail: msledzinska@onet.eu.
authors.forename: M
authors.initials: M
authors.lastname: Sledzińska-Dźwigał
authors.forename: Piotr
authors.initials: P
authors.lastname: Sobolewski
authors.forename: W
authors.initials: W
authors.lastname: Szczuchniak
mesh_terms: D000328:Adult; D015984:Causality; D016657:Cerebral Amyloid Angiopathy / Q000453:epidemiology* / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011044:Poland; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome