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THE PREDICTIVE RISK SCORE OF INTRACEREBRAL HEMORRHAGE IN ACUTE ISCHEMIC STROKE PATIENTS RECEIVING INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR (IV RT-PA) : A RETROSPECTIVE STUDY

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Abstract

Background: Acute ischemic stroke (AIS) is the most common neurological disorder causing neurological disability. Intravenous recombinant tissue-type plasminogen activator (IV rt-PA), an approved treatment of AIS by the FDA, is found to significantly increase the risk of intracerebral hemorrhage (ICH). This retrospective study is aimed to find the predictive score of ICH after IV rt-PA. Methods: Patients with AIS who were administered IV rt-PA in Songklanagarind Hospital during January, 2010 to June 2017 were eligible. The predictive risk scores were analyzed by multivariated logistic regression and generated Receiver operating characteristic curve (ROC curve). Results: After univariate analysis, significant predictors of ICH occurrence after IV rt-PA included National Institute of Health Stroke Score (NIHSS) at arrival, systolic blood pressure before given rt-PA, history of old cerebrovascular disease (CVA), the history of atrial fibrillation and platelet count (p value <0.05). Four independent factors found including NIHSS at arrival, systolic blood pressure (SBP), history of old CVA and platelet count were used to calculate the predictive risk score. The predictive risk scores were [2x(SBP)] +[9x(NIHSS)] +[174x(old CVA)]. The AUC of a ROC curve of the sum of predictive risk score was 0.71. The cutoff score was >370, the sensitivity and specificity were 0.84 and 0.30, respectively. Conclusion: The predictive risk score of ICH after thrombolysis is an easily practical tool to facilitate clinical decision and consider an intensive monitoring program in high-risk AIS patients after receiving IV rt-PA.

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© Copyright 2020 Morressier GmbH.
All rights reserved.