title: Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis.
abstract: OBJECTIVE
  We recently described TURN (Thrombolysis risk Using mRS and NIHSS), a computationally simple tool for predicting symptomatic intracerebral hemorrhage (sICH) after IV thrombolysis (rt-PA). Our objective was to compare TURN to existing scores for predicting sICH.
  
  
  METHODS
  Our internal dataset consisted of 210 ischemic stroke patients receiving IV rt-PA from January 2009 until July 2013 at Yale New Haven Hospital. Our external dataset included 303 patients who received IV rt-PA during the NINDS rt-PA trial. Predictive ability and goodness of fit were quantified by odds ratios (OR) and areas under the receiver operating characteristic curve (AUROC), and compared using unequal variance two-sample t-tests.
  
  
  RESULTS
  TURN predicted sICH with a higher OR than ASTRAL in the internal dataset (2.72 versus 1.10, P=0.05). We found no other significant differences in OR or AUROC between TURN and other scores in both datasets.
  
  
  CONCLUSIONS
  Despite its computational simplicity, TURN predicts sICH with accuracy comparable to existing scores.
authors.affiliation: Yale School of Medicine, New Haven, CT, USA.
authors.forename: David
authors.initials: D
authors.lastname: Asuzu
authors.affiliation: Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Karin
authors.initials: K
authors.lastname: Nystrӧm
authors.affiliation: Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Hardik
authors.initials: H
authors.lastname: Amin
authors.affiliation: Yale School of Medicine, New Haven, CT, USA; Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Schindler
authors.affiliation: Yale School of Medicine, New Haven, CT, USA; Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Wira
authors.affiliation: Yale School of Medicine, New Haven, CT, USA; Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: David
authors.initials: D
authors.lastname: Greer
authors.affiliation: Department of Neurology, Taipei Medical University Hospital and Shuang Ho Hospital, Taipei, Taiwan.
authors.forename: Nai Fang
authors.initials: NF
authors.lastname: Chi
authors.affiliation: Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Halliday
authors.affiliation: Yale School of Medicine, New Haven, CT, USA; Yale Department of Emergency Medicine, Division of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA. Electronic address: kevin.sheth@yale.edu.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Sheth
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; 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: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Adverse outcomes; IV Thrombolysis; Ischemic stroke; Predictive scores; Symptomatic intracerebral hemorrhage