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

BMC Neurology

Ziran Wang¹  Yuanying Yu²  Fengyun Wang³  Peng Yan⁴  Xiaohui Liu⁴  Qinjian Sun⁴  Yifeng Du⁴  Yuan Xue⁴  Jifeng Li⁴  Shan Li⁴  Yuanyuan Xiang⁴ 

[1] Department of Emergency, Linyi People’s Hospital Affiliated to Shandong University, Lin yi, Shandong, China;Department of Neurology, Haiyang People’s Hospital, Haiyang, Shandong, China;Department of Neurology, Liaocheng Brain Hospital, Liaocheng, Shandong, China;Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, 250021, Jinan, Shandong, PR China;

关键词: Stroke;    Intravenous thrombolysis;    Intracranial hemorrhages;    Predictor;    Risk factors;   

DOI  :  10.1186/s12883-021-02534-9

来源: Springer

【 摘 要 】

Background and purposeThis 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.MethodsWe 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.ResultsOf 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.ConclusionNIHSS 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.

【 授权许可】

CC BY