Risk Factors for Hemorrhagic Transformation After Intravenous Thrombolysis in Acute Cerebral Infarction: A Retrospective Single-Center Study

Xu, Xiaojun; Li, Changsong; Wan, Ting; Gu, Xiaobo; Zhu, Wenqi; Hao, Junjie; Bao, Huan; Zuo, Lian; Hu, Hui; Li, Gang

doi:10.1016/j.wneu.2017.01.091

Cited by 35 publications

(21 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous studies, [16][17][18][19][20][21][22] the present study showed that atrial fibrillation, the NIHSS score and the glucose level on admission were independent predictors of postthrombolysis ICH. However, these risk factors, identified using the conventional method with ORs, accounted for only a proportion of the stroke patients who presented with ICH after intravenous thrombolysis, rather than determining a probabilistic estimate for clinicians.…”

Section: Discussionsupporting

confidence: 92%

<p>Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis</p>

Yin¹,

Niu²,

Liang³

et al. 2020

NDT

View full text Add to dashboard Cite

Identifying stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. We aimed to develop and evaluate a nomogram for predicting the probability of ICH in acute ischemic stroke patients undergoing thrombolysis. Patients and Methods: A retrospective observational study was conducted using data from 345 patients at a single center. The patients were randomly dichotomized into training (2/3; n=233) and validation (1/3; n=112) sets. A prediction model was developed by using a multivariable logistic regression analysis. Results: The nomogram comprised three variables: the presence of atrial fibrillation (odds ratio [OR]: 4.92, 95% confidence interval [CI]: 2.09-11.57), the National Institutes of Health Stroke Scale (NIHSS) score (OR: 1.11, 95% CI: 1.04-1.18) and the glucose level on admission (OR: 1.27, 95% CI: 1.08-1.50). The areas under the receiver operating characteristic curve of the nomogram for the training and validation sets were 0.828 (0.753-0.903) and 0.801 (0.690-0.911), respectively. The Hosmer-Lemeshow test revealed good calibration in both the training and validation sets (P = 0.509 and P = 0.342, respectively). The calibration plot also demonstrated good agreement. A decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion: We developed an easy-to-use nomogram model to predict ICH, and the nomogram may provide risk assessments for subsequent treatment in stroke patients undergoing thrombolysis.

show abstract

Section: Discussionsupporting

confidence: 92%

<p>Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis</p>

Yin¹,

Niu²,

Liang³

et al. 2020

NDT

View full text Add to dashboard Cite

show abstract

“…HT is a life-threatening complication in acute ischemic stroke patients treated with intravenous thrombolysis, which can worsen the clinical course and outcome. Furthermore, HT occurs in approximately 10% to 43% of patients after thrombolysis [16,17]. In the present study, the rate of HT after thrombolysis was 15.3%, which was consistent with the findings of a previous investigation in China [17].…”

Section: Discussionsupporting

confidence: 93%

Body mass index is a risk factor for hemorrhagic transformation in older ischemic stroke patients after intravenous thrombolysis: a single center retrospective study

Miao¹,

X²,

Mu³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The aim of our study was to determine whether body mass index is a predictor of hemorrhagic transformation in acute ischemic stroke patients after intravenous thrombolysis. Methods: A retrospective observational study was conducted to recruit 261 participants from a single center in China (67.0% males, median age 65 years). A head computed tomography scan was performed after 24 hours to evaluate hemorrhagic transformation occurrence, and a computed tomography scan was performed immediately in cases of clinical worsening. Multivariate logistic regression was used to estimate the association between risk factors and hemorrhagic transformation in acute ischemic stroke patients after intravenous administration of recombinant tissue plasminogen activator. Results: Of 261 patients, 40 (15.3%) developed hemorrhagic transformation (55% males, median age 70 years). Body mass index was higher in patients with hemorrhagic transformation than in patients without hemorrhagic transformation (25.7 vs 23.7; P value, 0.013). The multivariate logistic regression model showed that body mass index was an independent predictor of hemorrhagic transformation in patients aged ≥ 73 years (odds ratio, 1.74; 95% confidence interval, 1.22-2.49) but not in patients aged < 73 years (odds ratio, 1.01; 95% confidence interval, 0.87-1.18). In addition, the odds ratio was 5.16 (95% confidence interval, 2.21-12.04) when the body mass index was ≥ 25 kg/m2 compared to a body mass index < 25 kg/m2. Conclusions: The present study demonstrated that body mass index was an independent predictor of hemorrhagic transformation in older acute ischemic stroke patients after intravenous thrombolysis. Keywords: Body mass index, Hemorrhagic transformation, Intravenous thrombolysis, Ischemic stroke, Older patients.

show abstract

“…Previous studies brie y mentioned the relationship between FIB and HT [26,34,35]. And we found that higher FIB may be associated with a higher incidence of HT among AIS patients, which is congruent with some reports [34,35].…”

Section: Discussionsupporting

confidence: 91%

Coagulation Functions Are Associated With Hemorrhagic Transformation in Non-Atrial Fibrillation Patients: A Case Control Study

Cheng

Chen

Zeng

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Hemorrhagic transformation (HT) is a serious neurological complication of acute ischemic stroke (AIS) after revascularization. The majority of AIS patients do not have atrial fibrillation (AF) which could also develop to HT. In this study, we aimed to explore whether coagulation parameters are risk factors of HT in non-AF patients.Methods: We consecutively enrolled 285 AIS patients with HT. Meanwhile, age- and sex-matched 285 AIS patients without HT were included. The diagnosis of HT was determined by brain CT or MRI during hospitalization. All patients were divided into two subgroups based on the presence of AF and explore the differences between the two subgroups. Blood samples were obtained within 24 hours of admission, and all patients were evenly classified into three tertiles according to platelet counts (PLT) levels.Results: In this study, we found the first PLT tertile (OR = 3.509, 95%CI = 1.268-9.711, P = 0.016) was independently associated with HT in non-AF patients, taking the third tertile as a reference. Meanwhile, we also found mean platelet volume (MPV) (OR = 0.605, 95%CI = 0.455-0.805, P = 0.001) and fibrinogen (FIB) (OR = 1.928, 95%CI = 1.346-2.760, P <0.001) were significantly associated with HT in non-AF patients. But in AF patients, coagulation parameters showed no significant difference. Meanwhile, we found the MPV (OR = 1.314, 95%CI = 1.032-1.675, P = 0.027) and FIB (OR = 1.298, 95%CI = 1.047-1.610, P = 0.018) were significantly associated with long-term outcomes in non-AF HT patients.Conclusions: Low PLT, low MPV and high FIB levels were independently associated with HT in non-AF patients. Additionaly, MPV and FIB levels were significantly associated with unfavorable long-term outcomes in non-AF HT patients. Our study showed that coagulation functions at admission may be beneficial for clinicians to recognize patients with high risk of HT at early stage and improve unfavorable long-term outcomes in non-AF patients.

show abstract

Risk Factors for Hemorrhagic Transformation After Intravenous Thrombolysis in Acute Cerebral Infarction: A Retrospective Single-Center Study

Cited by 35 publications

References 21 publications

<p>Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis</p>

<p>Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis</p>

Body mass index is a risk factor for hemorrhagic transformation in older ischemic stroke patients after intravenous thrombolysis: a single center retrospective study

Coagulation Functions Are Associated With Hemorrhagic Transformation in Non-Atrial Fibrillation Patients: A Case Control Study

Contact Info

Product

Resources

About