Journal of Stroke & Cerebrovascular Diseases
Volume 17, Issue 6 , Pages 331-333, November 2008

A Risk Score to Predict Intracranial Hemorrhage After Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke

  • Brett Cucchiara, MD

      Affiliations

    • Department of Neurology, University of Pennsylvania Medical Center, Philadelphia
    • Corresponding Author InformationAddress correspondence to Brett Cucchiara, MD, Department of Neurology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104.
    • ,
  • David Tanne, MD

      Affiliations

    • Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
    • ,
  • Steven R. Levine, MD

      Affiliations

    • Department of Neurology, Mount Sinai Medical Center, New York, New York
    • ,
  • Andrew M. Demchuk, MD

      Affiliations

    • Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
    • ,
  • Scott Kasner, MD

      Affiliations

    • Department of Neurology, University of Pennsylvania Medical Center, Philadelphia

Received 26 February 2008; accepted 18 March 2008.

Background

Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited.

Methods

Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each of 4 variables: age older than 60 years, baseline National Institutes of Health Stroke Scale score greater than 10, glucose greater than 8.325 mmol/L, and platelet count less than 150,000/mm3.

Results

Rate of any ICH increased with higher scores: 0 points, 2.6%; 1 point, 9.7%; 2 points, 15.1%; and greater than or equal to 3 points, 37.9%. The model had reasonable discriminatory capability (C-statistic 0.69). A similar pattern was seen with symptomatic and asymptomatic ICH separately, and with radiographically defined parenchymal hemorrhage.

Conclusion

A simple risk score may be useful for predicting postthrombolysis ICH.

Key Words: Intracerebral hemorrhage, thrombolysis, acute ischemic stroke, risk scores

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 Supported by an American Heart Association Fellow-to-Faculty Award (Dr. Cucchiara).

PII: S1052-3057(08)00084-0

doi:10.1016/j.jstrokecerebrovasdis.2008.03.012

Journal of Stroke & Cerebrovascular Diseases
Volume 17, Issue 6 , Pages 331-333, November 2008

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