Risk factors for hemorrhagic transformation following intravenous thrombolysis in acute cerebral infarction: a retrospective single center study.

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Risk factors for hemorrhagic transformation following intravenous thrombolysis in acute cerebral infarction: a retrospective single center study.

World Neurosurg. 2017 Feb 06;:

Authors: Xu X, Li C, Wan T, Gu X, Zhu W, Hao J, Bao H, Zuo L, Hu H, Li G

Abstract
OBJECTIVE: To investigate the risk factors for the hemorrhagic transformation (HT) following intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute cerebral infarction.
METHODS: Acute cerebral infarction patients receiving r-tPA thrombolysis in Shanghai Eastern Hospital were retrospectively studied. Based upon the cranial CT or MRI examination, after the intravenous thrombolysis, the patients were divided into two groups: HT group and non-HT group. The potential information was collected before or after thrombolysis.
RESULTS: A total of 162 patients were included in the analysis. The age ranged from 25 to 86 years, with an average value of 65.6 ± 10.6 years. The average time from disease onset to thrombolysis was 188 ± 53.1 minutes. Cranial CT or MRI showed that 20 patients (12.3%) had HT after thrombolysis. Using univariate analysis, history of atrial fibrillation, positive expression of urinary protein, high National Institute of Health Stroke Scale (NIHSS) before thrombolysis, we found that there was a significant difference between the HT and non-HT group (P < 0.05) in the level of mean systolic pressure (MSP) 24 h after thrombolysis. Multivariate logistic regression analysis indicated that age ≥ 80 years, MSP ≥ 140 mmHg, NIHSS, and fibrinogen concentration before thrombolysis were risk factors for the hemorrhagic transformation following thrombolysis in patients with acute cerebral infarction.
CONCLUSION: Age, MSP, NIHSS, and fibrinogen concentration before thrombolysis are risk factors for the hemorrhagic transformation following thrombolysis in acute cerebral infarction. These four factors should be carefully taken into account before thrombolysis.

PMID: 28185970 [PubMed - as supplied by publisher]

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