Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis

David Asuzu, Karin Nyström, Hardik Amin, Joseph Schindler, Charles Wira, David Greer, Nai-Fang Chi, Janet Halliday, Kevin N. Sheth

研究成果: 雜誌貢獻文章

17 引文 (Scopus)

摘要

Background: Intracerebral hemorrhage is a feared complication of IV thrombolytic (rt-PA) therapy. In recent years, at least 8 clinical scores have been proposed to predict either adverse outcome or symptomatic intracerebral hemorrhage (sICH) in patients undergoing rt-PA therapy. The purpose of this study was to evaluate the ability of these 8 scores to predict sICH in an independent clinical dataset. Methods: Clinical data was analyzed from consecutive patients (n = 210) receiving IV rt-PA therapy from January 2009 to December 2013 at Yale-New Haven Hospital. Eight scores were calculated for each patient: Stroke-TPI, DRAGON, SPAN-100, ASTRAL, PRS, HAT, SEDAN, and SITS-ICH. sICH was defined according to the NINDS study criteria. Univariate logistic regression was performed using each score as an independent variable and sICH as the dependent variable. Goodness of fit was tested by Receiver operating characteristic (ROC) analysis and by Hosmer–Lemeshow statistics. Results: sICH occurred in 12 patients (5.71 %) after IV rt-PA treatment. Only 4 scores predicted sICH with good accuracy (ROC area >0.7): DRAGON 0.76 (0.63, 0.89); Stroke-TPI 0.74 (0.61, 0.87); ASTRAL 0.72 (0.59, 0.86); and HAT 0.70 (0.55, 0.85), with odds ratios as follows: Stroke-TPI, 1.91 (1.26, 2.90); HAT, 1.67 (1.06, 2.62); DRAGON, 1.66 (1.21, 2.30); and ASTRAL, 1.10 (1.03, 1.16). Conclusions: Three scores showed good agreement with sICH: DRAGON, Stroke-TPI, and HAT with odds ratios substantially greater than 1. Stroke-TPI and HAT additionally benefited from low computational complexity and therefore performed best overall. Our results demonstrate the utility of clinical scores as predictors of sICH in acute ischemic stroke patients undergoing IV thrombolytic therapy.
原文英語
頁(從 - 到)229-233
頁數5
期刊Neurocritical Care
22
發行號2
DOIs
出版狀態已發佈 - 2015

指紋

Cerebral Hemorrhage
Stroke
ROC Curve
Odds Ratio
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid
National Institute of Neurological Disorders and Stroke
Thrombolytic Therapy
Therapeutics
Logistic Models

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

引用此文

Asuzu, D., Nyström, K., Amin, H., Schindler, J., Wira, C., Greer, D., ... Sheth, K. N. (2015). Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis. Neurocritical Care, 22(2), 229-233. https://doi.org/10.1007/s12028-014-0060-2

Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis. / Asuzu, David; Nyström, Karin; Amin, Hardik; Schindler, Joseph; Wira, Charles; Greer, David; Chi, Nai-Fang; Halliday, Janet; Sheth, Kevin N.

於: Neurocritical Care, 卷 22, 編號 2, 2015, p. 229-233.

研究成果: 雜誌貢獻文章

Asuzu, D, Nyström, K, Amin, H, Schindler, J, Wira, C, Greer, D, Chi, N-F, Halliday, J & Sheth, KN 2015, 'Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis', Neurocritical Care, 卷 22, 編號 2, 頁 229-233. https://doi.org/10.1007/s12028-014-0060-2
Asuzu, David ; Nyström, Karin ; Amin, Hardik ; Schindler, Joseph ; Wira, Charles ; Greer, David ; Chi, Nai-Fang ; Halliday, Janet ; Sheth, Kevin N. / Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis. 於: Neurocritical Care. 2015 ; 卷 22, 編號 2. 頁 229-233.
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title = "Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis",
abstract = "Background: Intracerebral hemorrhage is a feared complication of IV thrombolytic (rt-PA) therapy. In recent years, at least 8 clinical scores have been proposed to predict either adverse outcome or symptomatic intracerebral hemorrhage (sICH) in patients undergoing rt-PA therapy. The purpose of this study was to evaluate the ability of these 8 scores to predict sICH in an independent clinical dataset. Methods: Clinical data was analyzed from consecutive patients (n = 210) receiving IV rt-PA therapy from January 2009 to December 2013 at Yale-New Haven Hospital. Eight scores were calculated for each patient: Stroke-TPI, DRAGON, SPAN-100, ASTRAL, PRS, HAT, SEDAN, and SITS-ICH. sICH was defined according to the NINDS study criteria. Univariate logistic regression was performed using each score as an independent variable and sICH as the dependent variable. Goodness of fit was tested by Receiver operating characteristic (ROC) analysis and by Hosmer–Lemeshow statistics. Results: sICH occurred in 12 patients (5.71 {\%}) after IV rt-PA treatment. Only 4 scores predicted sICH with good accuracy (ROC area >0.7): DRAGON 0.76 (0.63, 0.89); Stroke-TPI 0.74 (0.61, 0.87); ASTRAL 0.72 (0.59, 0.86); and HAT 0.70 (0.55, 0.85), with odds ratios as follows: Stroke-TPI, 1.91 (1.26, 2.90); HAT, 1.67 (1.06, 2.62); DRAGON, 1.66 (1.21, 2.30); and ASTRAL, 1.10 (1.03, 1.16). Conclusions: Three scores showed good agreement with sICH: DRAGON, Stroke-TPI, and HAT with odds ratios substantially greater than 1. Stroke-TPI and HAT additionally benefited from low computational complexity and therefore performed best overall. Our results demonstrate the utility of clinical scores as predictors of sICH in acute ischemic stroke patients undergoing IV thrombolytic therapy.",
keywords = "Acute stroke, Critical care, Intracerebral hemorrhage, Ischemic stroke, Neuro-ICU",
author = "David Asuzu and Karin Nystr{\"o}m and Hardik Amin and Joseph Schindler and Charles Wira and David Greer and Nai-Fang Chi and Janet Halliday and Sheth, {Kevin N.}",
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T1 - Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis

AU - Asuzu, David

AU - Nyström, Karin

AU - Amin, Hardik

AU - Schindler, Joseph

AU - Wira, Charles

AU - Greer, David

AU - Chi, Nai-Fang

AU - Halliday, Janet

AU - Sheth, Kevin N.

PY - 2015

Y1 - 2015

N2 - Background: Intracerebral hemorrhage is a feared complication of IV thrombolytic (rt-PA) therapy. In recent years, at least 8 clinical scores have been proposed to predict either adverse outcome or symptomatic intracerebral hemorrhage (sICH) in patients undergoing rt-PA therapy. The purpose of this study was to evaluate the ability of these 8 scores to predict sICH in an independent clinical dataset. Methods: Clinical data was analyzed from consecutive patients (n = 210) receiving IV rt-PA therapy from January 2009 to December 2013 at Yale-New Haven Hospital. Eight scores were calculated for each patient: Stroke-TPI, DRAGON, SPAN-100, ASTRAL, PRS, HAT, SEDAN, and SITS-ICH. sICH was defined according to the NINDS study criteria. Univariate logistic regression was performed using each score as an independent variable and sICH as the dependent variable. Goodness of fit was tested by Receiver operating characteristic (ROC) analysis and by Hosmer–Lemeshow statistics. Results: sICH occurred in 12 patients (5.71 %) after IV rt-PA treatment. Only 4 scores predicted sICH with good accuracy (ROC area >0.7): DRAGON 0.76 (0.63, 0.89); Stroke-TPI 0.74 (0.61, 0.87); ASTRAL 0.72 (0.59, 0.86); and HAT 0.70 (0.55, 0.85), with odds ratios as follows: Stroke-TPI, 1.91 (1.26, 2.90); HAT, 1.67 (1.06, 2.62); DRAGON, 1.66 (1.21, 2.30); and ASTRAL, 1.10 (1.03, 1.16). Conclusions: Three scores showed good agreement with sICH: DRAGON, Stroke-TPI, and HAT with odds ratios substantially greater than 1. Stroke-TPI and HAT additionally benefited from low computational complexity and therefore performed best overall. Our results demonstrate the utility of clinical scores as predictors of sICH in acute ischemic stroke patients undergoing IV thrombolytic therapy.

AB - Background: Intracerebral hemorrhage is a feared complication of IV thrombolytic (rt-PA) therapy. In recent years, at least 8 clinical scores have been proposed to predict either adverse outcome or symptomatic intracerebral hemorrhage (sICH) in patients undergoing rt-PA therapy. The purpose of this study was to evaluate the ability of these 8 scores to predict sICH in an independent clinical dataset. Methods: Clinical data was analyzed from consecutive patients (n = 210) receiving IV rt-PA therapy from January 2009 to December 2013 at Yale-New Haven Hospital. Eight scores were calculated for each patient: Stroke-TPI, DRAGON, SPAN-100, ASTRAL, PRS, HAT, SEDAN, and SITS-ICH. sICH was defined according to the NINDS study criteria. Univariate logistic regression was performed using each score as an independent variable and sICH as the dependent variable. Goodness of fit was tested by Receiver operating characteristic (ROC) analysis and by Hosmer–Lemeshow statistics. Results: sICH occurred in 12 patients (5.71 %) after IV rt-PA treatment. Only 4 scores predicted sICH with good accuracy (ROC area >0.7): DRAGON 0.76 (0.63, 0.89); Stroke-TPI 0.74 (0.61, 0.87); ASTRAL 0.72 (0.59, 0.86); and HAT 0.70 (0.55, 0.85), with odds ratios as follows: Stroke-TPI, 1.91 (1.26, 2.90); HAT, 1.67 (1.06, 2.62); DRAGON, 1.66 (1.21, 2.30); and ASTRAL, 1.10 (1.03, 1.16). Conclusions: Three scores showed good agreement with sICH: DRAGON, Stroke-TPI, and HAT with odds ratios substantially greater than 1. Stroke-TPI and HAT additionally benefited from low computational complexity and therefore performed best overall. Our results demonstrate the utility of clinical scores as predictors of sICH in acute ischemic stroke patients undergoing IV thrombolytic therapy.

KW - Acute stroke

KW - Critical care

KW - Intracerebral hemorrhage

KW - Ischemic stroke

KW - Neuro-ICU

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