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Predictors of Functional Outcome After Symptomatic Intracranial Hemorrhage Complicating Intravenous Thrombolysis: Results From the SITS-ISTR.

2023-10Text Open access
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dc.contributor.authorTsivgoulis, Georgios
dc.contributor.authorPalaiodimou, Lina
dc.contributor.authorStefanou, Maria-Ioanna
dc.contributor.authorTheodorou, Aikaterini
dc.contributor.authorKõrv, Janika
dc.contributor.authorPaiva Nunes, Ana
dc.contributor.authorCandelaresi, Paolo
dc.contributor.authorDall'Ora, Elisa
dc.contributor.authorSariaslani, Payam
dc.contributor.authorProvinciali, Leandro
dc.contributor.authorConforto, Adriana B
dc.contributor.authorCidrao, Alan Alves de Lima
dc.contributor.authorKarapanayiotides, Theodore
dc.contributor.authorAhmed, Niaz
dc.date.accessioned2025-08-08T14:26:49Z
dc.date.available2025-08-08T14:26:49Z
dc.date.issued2023-10
dc.description.abstractBackground and purpose: Several risk factors of symptomatic intracerebral hemorrhage (SICH) following intravenous thrombolysis for acute ischaemic stroke have been established. However, potential predictors of good functional outcome post-SICH have been less studied. Methods: Patient data registered in the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) from 2005 to 2021 were used. Acute ischaemic stroke patients who developed post intravenous thrombolysis SICH according to the SITS Monitoring Study definition were analyzed to identify predictors of functional outcomes. Results: A total of 1679 patients with reported SICH were included, out of which only 2.8% achieved good functional outcome (modified Rankin Scale scores of 0-2), whilst 80.9% died at 3 months. Higher baseline National Institutes of Health Stroke Scale (NIHSS) score and 24-h ΔNIHSS score were independently associated with a lower likelihood of achieving both good and excellent functional outcomes at 3 months. Baseline NIHSS and hematoma location (presence of both SICHs, defined as remote and local SICH concurrently; n = 478) were predictors of early mortality within 24 h. Independent predictors of 3-month mortality were age, baseline NIHSS, 24-h ΔNIHSS, admission serum glucose values and hematoma location (both SICHs). Age, baseline NIHSS score, 24-h ΔNIHSS, hyperlipidemia, prior stroke/transient ischaemic attack, antiplatelet treatment, diastolic blood pressure at admission, glucose values on admission and SICH location (both SICHs) were associated with reduced disability at 3 months (≥1-point reduction across all modified Rankin Scale scores). Patients with remote SICH (n = 219) and local SICH (n = 964) had comparable clinical outcomes, both before and after propensity score matching. Conclusions: Symptomatic intracerebral hemorrhage presents an alarmingly high prevalence of adverse clinical outcomes, with no difference in clinical outcomes between remote and local SICH.eng
dc.identifier.citationEur J Neurol . 2023 Oct;30(10):3161-3171. doi: 10.1111/ene.15968.
dc.identifier.doiEur J Neurol . 2023;30(10):3161-3171. doi: 10.1111/ene.15968.
dc.identifier.pmid37410547
dc.identifier.urihttp://hdl.handle.net/10400.17/5141
dc.language.isoeng
dc.peerreviewedyes
dc.publisherWiley
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHSJ NEU
dc.subjectHumans
dc.subjectGlucose
dc.subjectBrain Ischemia* / complications
dc.subjectBrain Ischemia* / drug therapy
dc.subjectCerebral Hemorrhage / complications
dc.subjectChild
dc.subjectPreschool
dc.subjectFibrinolytic Agents / adverse effects
dc.subjectIschemic Stroke* / complications
dc.subjectStroke* / etiology
dc.subjectThrombolytic Therapy / adverse effects
dc.subjectThrombolytic Therapy / methods
dc.subjectTissue Plasminogen Activator / adverse effects
dc.subjectTreatment Outcome
dc.titlePredictors of Functional Outcome After Symptomatic Intracranial Hemorrhage Complicating Intravenous Thrombolysis: Results From the SITS-ISTR.eng
dc.typetext
dspace.entity.typePublication
oaire.citation.endPage3171
oaire.citation.issue10
oaire.citation.startPage3161
oaire.citation.titleEuropean Journal of Neurology
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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