title: External validation of the SEDAN score: The real world practice of a single center.
abstract: OBJECTIVE
  Symptomatic intracranial hemorrhage (sICH) is the most serious adverse event in stroke patients who received i.v. rt-PA and is usually associated with poor outcomes. The SEDAN score is built up to predict sICH. We aim to externally validate the SEDAN score in Thai patients from single center in the real world practice.
  
  
  METHODS
  The SEDAN score of stroke patients treated with intravenous rt-PA at Thammasat University Hospital from January 2010 to June 2012 was calculated. Patients were divided into three groups including symptomatic intracranial hemorrhage (sICH), asymptomatic intracranial hemorrhage (AsICH) and no intracerebral hemorrhage (NoICH). The primary outcome of analyses was sICH. Each parameter of the SEDAN score and correlation between score and sICH were analyzed with univariate and multivariate model.
  
  
  RESULTS
  295 patients (18.6% of stroke admission) were treated with i.v. rt-PA. 13 patients (4.4%) had sICH and 31 patients (10.4%) had AsICH. Baseline blood sugar >12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10(SEDAN) were associated with sICH by univariate analysis (P value = 0.018, <0.001, <0.001, 0.002 and 0.027 respectively). The rate of sICH occurrence was increased in accordance with the increasing of the SEDAN score. By multivariate analysis, odds ratio of baseline blood sugar >12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10 were 1.248, 2.503, 1.107, 1.532 and 1.263 respectively.
  
  
  CONCLUSIONS
  The SEDAN score was practical to use and predictive in Thai population. Each parameter of the SEDAN score was an independent risk factor for sICH after treatment with i.v. rt-PA.
authors.affiliation: Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
authors.forename: Sombat
authors.initials: S
authors.lastname: Muengtaweepongsa
authors.affiliation: Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
authors.forename: Pornpoj
authors.initials: P
authors.lastname: Prapa-Anantachai
authors.affiliation: Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
authors.forename: Pornpatr A
authors.initials: PA
authors.lastname: Dharmasaroja
authors.affiliation: Department of Surgery, Faculty of Surgery, Thammasat University, Pathum Thani, Thailand.
authors.forename: Pattarawit
authors.initials: P
authors.lastname: Rukkul
authors.affiliation: Department of Surgery, Faculty of Surgery, Thammasat University, Pathum Thani, Thailand.
authors.forename: Pornchai
authors.initials: P
authors.lastname: Yodvisitsak
keywords: Acute ischemic stroke; intravenous recombinant tissue plasminogen activator; symptomatic intracranial hemorrhage; the SEDAN score