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Multicenter Study
. 2022 Jan 3;22(1):6.
doi: 10.1186/s12883-021-02534-9.

Predictors for symptomatic intracranial hemorrhage after intravenous thrombolysis with acute ischemic stroke within 6 h in northern China: a multicenter, retrospective study

Yuan Xue  1 , Shan Li  1 , Yuanyuan Xiang  1 , Ziran Wang  2 , Fengyun Wang  3 , Yuanying Yu  4 , Peng Yan  1 , Xiaohui Liu  1 , Qinjian Sun  1 , Yifeng Du  1 , Jifeng Li  5
Affiliations
Multicenter Study

Predictors for symptomatic intracranial hemorrhage after intravenous thrombolysis with acute ischemic stroke within 6 h in northern China: a multicenter, retrospective study

Yuan Xue et al. BMC Neurol. .

Abstract

Background and purpose: This study assessed the predictive factors for symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke (AIS) after receiving intravenous thrombolysis (IVT) within 6 h in northern China.

Methods: We retrospectively analyzed ischemic stroke patients who were treated with IVT between November 2016 and December 2018 in 19 hospitals in Shandong Province, China. Potential predictors of sICH were investigated using univariate and multivariate analyses.

Results: Of the 1293 enrolled patients (845 men, aged 62 ± 11 years), 33 (2.6%) developed sICH. The patients with sICH had increased coronary heart disease (36.4% vs. 13.7%, P = 0.001), more severe stroke (mean National Institutes of Health Stroke Scale [NIHSS] score on admission of 14 vs.7, P < 0.001), longer door-to-needle time [DNT] (66 min vs. 50 min, P < 0.001), higher blood glucose on admission, higher white blood cell counts (9000/mm3 vs. 7950/mm3, P = 0.004) and higher neutrophils ratios (73.4% vs. 67.2%, P = 0.006) et al. According to the results of multivariate analysis, the frequency of sICH was independently associated with the NIHSS score (OR = 3.38; 95%CI [1.50-7.63]; P = 0.003), DNT (OR = 4.52; 95%CI [1.69-12.12]; P = 0.003), and white blood cell count (OR = 3.59; 95%CI [1.50-8.61]; P = 0.004). When these three predictive factors were aggregated, compared with participants without any factors, the multi-adjusted odds ratios (95% confidence intervals) of sICH for persons concurrently having one, two or three of these factors were 2.28 (0.25-20.74), 15.37 (1.96-120.90) and 29.05 (3.13-270.11), respectively (P for linear trend < 0.001), compared with participants without any factors.

Conclusion: NIHSS scores higher than 10 on admission, a DNT > 50 min, and a white blood cell count ≥9000/mm3 were independent risk factors for sICH in Chinese patients within 6 h after IVT for AIS.

Keywords: Intracranial hemorrhages; Intravenous thrombolysis; Predictor; Risk factors; Stroke.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 guidelines for the early Management of Patients with Acute Ischemic Stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46–e110. doi: 10.1161/str.0000000000000158. - DOI - PubMed
    1. Yuan Z, Wang B, Li F, Wang J, Zhi J, Luo E, et al. Intravenous thrombolysis guided by a telemedicine consultation system for acute ischaemic stroke patients in China: the protocol of a multicentre historically controlled study. BMJ Open. 2015;5(5):e006704. doi: 10.1136/bmjopen-2014-006704. - DOI - PMC - PubMed
    1. Strbian D, Sairanen T, Meretoja A, Pitkäniemi J, Putaala J, Salonen O, et al. Patient outcomes from symptomatic intracerebral hemorrhage after stroke thrombolysis. Neurology. 2011;77(4):341–348. doi: 10.1212/WNL.0b013e3182267b8c. - DOI - PubMed
    1. Lee RS, Ok YC, Lim JS, Lim BC, Cho KY, Lee MC. Outcome evaluation of intravenous infusion of urokinase for acute ischemic stroke. Chonnam Med J. 2012;48(1):52–56. doi: 10.4068/cmj.2012.48.1.52. - DOI - PMC - PubMed
    1. Liu M, Pan Y, Zhou L, Wang Y. Predictors of post-thrombolysis symptomatic intracranial hemorrhage in Chinese patients with acute ischemic stroke. PLoS One. 2017;12(9):e0184646. doi: 10.1371/journal.pone.0184646. - DOI - PMC - PubMed

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