Derivation and Validation of a Scoring System for Intravenous Tissue Plasminogen Activator Use in Asian Patients

Yeo, Leonard L.L.; Chien, Shih-Chao; Lin, Jainn-Jim; Liow, Chia-Wei; Lee, Jiann-Der; Peng, Tsung-I; Luen, Teoh Hock; Sharma, Vijay K.; Chan, Bernard P.L.; Lee, Tsong‐Hai

doi:10.1016/j.jstrokecerebrovasdis.2017.03.033

Cited by 17 publications

(28 citation statements)

References 28 publications

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“…However, AF has not been considered in previous risk scoring systems for ICH after thrombolysis [4,7,17,18,24,25]. Yeo et al reported a scoring system using nomogram based on three variables (presence of AF, glucose level and NIHSS score) was a practical tool to predict the risk of ICH after thrombolysis [12]. In our study, the AF prevalence at baseline was higher in patients with ICH and was an independent risk factor for ICH in stroke patients undergoing thrombolysis.…”

Section: Studies Have Reported Additional Predictive Factors For Postmentioning

confidence: 55%

“…To the best of our knowledge, there have only 2 works carried out on nomograms for individualized prediction of the ICH probability in acute ischemic stroke patients undergoing thrombolysis [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…The STARTING-SICH nomogram including 10 variables was designed to predict sICH in stroke patients treated with intravenous thrombolysis in a large cohort study of Italy [11], but it has not been external validated in Asian patients and the data on ethnicity are lacking. The other nomogram model including 3 variables (present of AF, NIHSS score and glucose level on admission) was developed in Asian patients [12]. However, the study did not include the information about the total dose of r-PA, and the risk of ICH is reported higher in Asian populations at standard doses [15].…”

Section: Discussionmentioning

confidence: 99%

“…We included both symptomatic and asymptomatic postthrombolysis ICH as the outcome for the scoring systems, as in previous studies [7,12]. Many reports have demonstrated that both symptomatic and asymptomatic ICH may worsen clinical outcomes [7,26,27], and influence the timing of reintroducing antithrombotic treatment after r-tPA treatment.…”

Section: Studies Have Reported Additional Predictive Factors For Postmentioning

confidence: 99%

“…It is a graphical statistical instrument that incorporates some variables to develop a scoring system, which reflects the individual and precise risk probability. However, the prognostic nomogram for ICH events in stroke patients undergoing thrombolysis is currently lacking [11,12].…”

Section: Introductionmentioning

confidence: 99%

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A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis

Miao

Yin

Liang

et al. 2019

Preprint

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Background: Identiﬁcation of stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. However, studies in this area spare.We aimed to develop a nomogram by adding atrial fibrillation to the Multicenter Stroke Survey (MSS) score to predict the probability of ICH in acute ischemic stroke patients undergoing thrombolysis. Methods: A retrospective observational study was conducted with 287 participants from a single center (67.2% males, median age 65 years). Head computed tomography scan was performed after 24 hour to evaluate ICH occurrence, and a computed tomography scan was done immediately in case of clinical worsening. The risk factors associated with ICH were analysed. Based on multivariate logistic model, a nomogram was generated for ICH on the basis of atrial fibrillation and the MSS score. We assessed the discriminative performance by using the area under curve (AUC) of receiver-operating characteristic (ROC) and calibration of risk prediction model by using calibration plot. Results: A total of 41(14.3%) ICH events occurred.The MSS score and atrial fibrillation were independent predictors of ICH in multivariate logistic regression analysis. Discrimination of the nomogram was superior to the MSS score alone (0.794 vs 0.741; P=0.034). The model was internally validated by using bootstrap (1000 samples) with AUC-ROC of 0.795. The calibration plot showed good agreement. Conclusion: We developed and internally validated a new nomogram using the MSS score and atrial fibrillation as predictors.The nomogram is a simple and accurate tool for predicting ICH in acute ischemic stroke patients undergoing thrombolysis. Further studies are warranted to validate our findings.

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Section: Studies Have Reported Additional Predictive Factors For Postmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Studies Have Reported Additional Predictive Factors For Postmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis

Miao

Yin

Liang

et al. 2019

Preprint

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Recovery of walking ability in stroke patients through postacute care rehabilitation

Chu¹,

Lee²,

Chen³

et al. 2023

Biomedical Journal

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Predictive model for the risk of hemorrhagic transformation after rt-PA intravenous thrombolysis in patients with acute ischemic stroke: A systematic review and meta-analysis

Zhong,

An,

Kong

et al. 2024

Clinical Neurology and Neurosurgery

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Derivation and Validation of a Scoring System for Intravenous Tissue Plasminogen Activator Use in Asian Patients

Cited by 17 publications

References 28 publications

A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis

A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis

Recovery of walking ability in stroke patients through postacute care rehabilitation

Predictive model for the risk of hemorrhagic transformation after rt-PA intravenous thrombolysis in patients with acute ischemic stroke: A systematic review and meta-analysis

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