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Predictors of Hemorrhage Volume after Intravenous Thrombolysis

Title
Predictors of Hemorrhage Volume after Intravenous Thrombolysis
Author
고성호
Keywords
Intracranial hemorrhage; thrombolytic therapy; patient outcome assessment; cerebral infarction
Issue Date
2016-10
Publisher
ELSEVIER SCIENCE BV
Citation
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v. 25, NO 10, Page. 2543-2548
Abstract
Background: Symptomatic intracerebral hemorrhage (sICH) is one of the most feared complications after administration of intravenous recombinant tissue plasminogen activator (IV rtPA). The aim of this study was to determine correlations between hemorrhage volume (HV) after IV rtPA treatment and risk factors for sICH. Methods: We analyzed 318 patients from the stroke registries of 4 hospitals in Korea. We confirmed hemorrhage by computed tomography (CT) or magnetic resonance imaging within 36 hours. Patient groups were classified by HV (0, 0-10, 10-25, and greater than 25 mL). Based on the HV, we evaluated the following: (1) predictors for hemorrhage; (2) rates of sICH according to various sICH definitions; and (3) 3-month functional outcomes after IV rtPA treatment. Results: Among the 318 patients, hemorrhage occurred in 72 patients. HV was significantly correlated with atrial fibrillation (OR = 3.38, 95% CI = 1.87-6.09), early CT changes (OR = 3.17, 95% CI = 1.69-5.93), and dense artery sign (OR = 1.90, 95% CI = 1.07-3.39). Compared with the groups with HV less than 25 mL, patients with an HV of greater than 25 mL were more likely to have higher mortality rates (33.3% versus 11.8%) and worse outcomes at 3 months (good: 8.3% versus 50.3%; excellent: 0% versus 33.7%). Conclusions: HV after IV rtPA is an important predictor of clinical outcomes. Atrial fibrillation, early CT changes, and dense artery sign were significantly associated with large HVs; therefore, these patient factors might be considered before and after thrombolytic treatment.
URI
https://www.sciencedirect.com/science/article/pii/S1052305716301732?via%3Dihubhttp://repository.hanyang.ac.kr/handle/20.500.11754/100544
ISSN
1052-3057; 1532-8511
DOI
10.1016/j.jstrokecerebrovasdis.2016.06.035
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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