Analysis of Risk Factors Increased Hemorrhagic Transformation after Acute Ischemic Stroke

Wan-Qian Ge, Jie Chen, Hong Pan, Fei Chen, Cheng-Ye Zhou
Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association 2018 September 11

BACKGROUND: The purpose of this study was to analyze the risk factors of hemorrhagic transformation (HT) after intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute ischemic stroke (AIS).

METHODS: We included 199 consecutive patients in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to October 2017 with a diagnosis of AIS. The patients were divided into 2 groups: HT and non-HT. The related risk factors were recruited before and after receiving r-tPA thrombolysis.

RESULTS: Using univariate analysis, we found that there was a significant difference between the HT and non-HT group (P < .05) in the level of age, atrial fibrillation, baseline National Institute of Health Stroke Scale (NIHSS) score and NIHSS score after 2hours of thrombolytic therapy, hyperlipidemia. Multivariate logistic regression analysis indicated that NIHSS score after 2hours of thrombolytic therapy (odds ratio [OR] = 1.091, 95% confidence interval [CI] = 1.015-1.173 P = .018) and atrial fibrillation (OR = 2.188, 95%CI  = 1.024-4.672 P = .043) are the risk factors of HT.

CONCLUSIONS: NIHSS score after 2hours of thrombolytic therapy and atrial fibrillation were risk factors for HT after thrombolysis. Age (OR = 1.022, 95%CI = .988-1.056 P = .205), Hyperlipidemia (OR = .591, 95%CI = .29-1.206 P = .148), and Baseline NIHSS score (OR = .998, 95%CI = .914-1.089 P = .043) were not significant independent predictors but showed an association with HT. These 5 factors should be carefully taken into account.

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