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Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke.
J Stroke Cerebrovasc Dis. 2014 Jan; 23(1):7-11.JS

Abstract

Recombinant tissue-plasminogen activator (rt-PA) therapy improves functional outcome in patients with acute ischemic stroke (AIS) but is associated with serious complications, including symptomatic intracerebral hemorrhage (sICH). This study aimed to determine the independent predictors of in-hospital mortality (IHM) and the risk of sICH after rt-PA therapy. A total of 1007 patients (mean age, 72 ± 12 years; 52% women; mean National Institutes of Health Stroke Scale [NIHSS] score, 11.6 ± 5.6) with AIS treated with rt-PA were enrolled in this study during a 42-month period beginning in November 2007. Univariate and multivariate regression analyses were performed to estimate the predictors of IHM. Eighty-three of the 1007 patients (8.2%) died during hospitalization (mean duration of hospitalization, 10 ± 1.8 days). Logistic regression estimated the following independent predictors for IHM: age ≥80 years (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-3.0; P = .031), aphasia (OR, 2.0; 95% CI, 1.1-3.4; P = .017), altered consciousness (OR, 3.6; 95% CI, 2.0-6.2; P < .001), hypertension (OR, 4; 95% CI, 1.4-11.6; P = 0.012), sICH (OR, 5.9; 95% CI, 2.9-11.9; P < 0.001), and pneumonia during hospitalization (OR, 3.0; 95% CI, 1.8-5.0; P < .001). After rt-PA therapy, 58 patients (5.8%) sustained sICH, 16 (28%) of whom died. Increased age (P = .008), higher NIHSS score (P = .011), and atrial fibrillation (P = .025) were correlated with sICH. The findings from this study may help clinicians estimate the prognosis and risk of sICH in patients with AIS treated with rt-PA.

Authors+Show Affiliations

Department of Neurology, Schleswig-Holstein University Hospital, Lübeck, Germany. Electronic address: Mohamed.al-khaled@neuro.uni-luebeck.de.Institute of Social Medicine, University of Lübeck, Lübeck, Germany.Department of Neurology, Schleswig-Holstein University Hospital, Lübeck, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22578915

Citation

Al-Khaled, Mohamed, et al. "Predictors of In-hospital Mortality and the Risk of Symptomatic Intracerebral Hemorrhage After Thrombolytic Therapy With Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 23, no. 1, 2014, pp. 7-11.
Al-Khaled M, Matthis C, Eggers J. Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2014;23(1):7-11.
Al-Khaled, M., Matthis, C., & Eggers, J. (2014). Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 23(1), 7-11. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.04.004
Al-Khaled M, Matthis C, Eggers J. Predictors of In-hospital Mortality and the Risk of Symptomatic Intracerebral Hemorrhage After Thrombolytic Therapy With Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2014;23(1):7-11. PubMed PMID: 22578915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. AU - Al-Khaled,Mohamed, AU - Matthis,Christine, AU - Eggers,Jürgen, Y1 - 2012/05/11/ PY - 2012/01/22/received PY - 2012/02/22/revised PY - 2012/04/08/accepted PY - 2012/5/15/entrez PY - 2012/5/15/pubmed PY - 2014/8/26/medline KW - Stroke treatment KW - complication KW - epidemiology KW - outcome KW - prognosis SP - 7 EP - 11 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 23 IS - 1 N2 - Recombinant tissue-plasminogen activator (rt-PA) therapy improves functional outcome in patients with acute ischemic stroke (AIS) but is associated with serious complications, including symptomatic intracerebral hemorrhage (sICH). This study aimed to determine the independent predictors of in-hospital mortality (IHM) and the risk of sICH after rt-PA therapy. A total of 1007 patients (mean age, 72 ± 12 years; 52% women; mean National Institutes of Health Stroke Scale [NIHSS] score, 11.6 ± 5.6) with AIS treated with rt-PA were enrolled in this study during a 42-month period beginning in November 2007. Univariate and multivariate regression analyses were performed to estimate the predictors of IHM. Eighty-three of the 1007 patients (8.2%) died during hospitalization (mean duration of hospitalization, 10 ± 1.8 days). Logistic regression estimated the following independent predictors for IHM: age ≥80 years (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-3.0; P = .031), aphasia (OR, 2.0; 95% CI, 1.1-3.4; P = .017), altered consciousness (OR, 3.6; 95% CI, 2.0-6.2; P < .001), hypertension (OR, 4; 95% CI, 1.4-11.6; P = 0.012), sICH (OR, 5.9; 95% CI, 2.9-11.9; P < 0.001), and pneumonia during hospitalization (OR, 3.0; 95% CI, 1.8-5.0; P < .001). After rt-PA therapy, 58 patients (5.8%) sustained sICH, 16 (28%) of whom died. Increased age (P = .008), higher NIHSS score (P = .011), and atrial fibrillation (P = .025) were correlated with sICH. The findings from this study may help clinicians estimate the prognosis and risk of sICH in patients with AIS treated with rt-PA. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/22578915/Predictors_of_in_hospital_mortality_and_the_risk_of_symptomatic_intracerebral_hemorrhage_after_thrombolytic_therapy_with_recombinant_tissue_plasminogen_activator_in_acute_ischemic_stroke_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(12)00101-2 DB - PRIME DP - Unbound Medicine ER -