title: TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis.
abstract: BACKGROUND
  IV Thrombolysis (rt-PA) for ischemic stroke treatment carries a substantial risk for symptomatic intracerebral hemorrhage (sICH). Our purpose was to develop a computationally simple and accurate sICH predictor METHODS : Our derivation dataset consisted of 210 ischemic stroke patients receiving IV rt-PA from January 2009 until July 2013 at Yale-New Haven Hospital. Our validation dataset included 303 patients who received IV rt-PA during the NINDS rt-PA trial. Independent sICH predictors were identified by logistic regression and combined to form the TURN score. Predictive ability and goodness of fit were quantified by odds ratios (OR) and areas under the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  3 out of 17 clinical parameters were identified as independent predictors of sICH: prestroke mRS score (OR 1.54, P = 0.02), baseline NIHSS score (OR 1.13, P = 0.002), and platelet count (OR 0.99, P = 0.04). We combined these three parameters to form the TURNP score. For added simplicity, prestroke mRS score and baseline NIHSS score alone were also combined to form the TURN score, and predicted sICH without a significant drop in OR or AUROC.
  
  
  CONCLUSIONS
  We developed a new score for predicting sICH after IV thrombolysis. Our score is simple and with acceptable accuracy, making it ideal for use in the hyperacute stroke setting.
authors: Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA, david.asuzu@yale.edu.
authors: David
authors: D
authors: Asuzu
authors: Karin
authors: K
authors: Nyström
authors: Hardik
authors: H
authors: Amin
authors: Joseph
authors: J
authors: Schindler
authors: Charles
authors: C
authors: Wira
authors: David
authors: D
authors: Greer
authors: Nai Fang
authors: NF
authors: Chi
authors: Janet
authors: J
authors: Halliday
authors: Kevin N
authors: KN
authors: Sheth
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D010959:Tissue Plasminogen Activator