| Literature DB >> 31233386 |
Manuel Cappellari1, Salvatore Mangiafico2, Valentina Saia3, Giovanni Pracucci4,5, Sergio Nappini2, Patrizia Nencini4,5, Daniel Konda6, Fabrizio Sallustio7, Stefano Vallone8, Andrea Zini9, Sandra Bracco10, Rossana Tassi11, Mauro Bergui12, Paolo Cerrato13, Antonio Pitrone14, Francesco Grillo15, Andrea Saletti16, Alessandro De Vito17, Roberto Gasparotti18, Mauro Magoni19, Edoardo Puglielli20, Alfonsina Casalena21, Francesco Causin22, Claudio Baracchini23, Lucio Castellan24, Laura Malfatto25, Roberto Menozzi26, Umberto Scoditti27, Chiara Comelli28, Enrica Duc29, Alessio Comai30, Enrica Franchini31, Mirco Cosottini32, Michelangelo Mancuso33, Simone Peschillo34, Manuela De Michele35, Andrea Giorgianni36, Maria Luisa Delodovici37, Elvis Lafe38, Maria Federica Denaro39, Nicola Burdi40, Saverio Internò41, Nicola Cavasin42, Adriana Critelli43, Luigi Chiumarulo44, Marco Petruzzellis45, Marco Doddi46, Antonio Carolei47, William Auteri48, Alfredo Petrone49, Riccardo Padolecchia50, Tiziana Tassinari3, Marco Pavia51, Paolo Invernizzi52, Gianni Turcato53, Stefano Forlivesi1, Elisa Francesca Maria Ciceri54, Bruno Bonetti1, Domenico Inzitari4,5, Danilo Toni35.
Abstract
Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.Entities:
Keywords: contraindications; logistic models; nomograms; standard of care; thrombectomy
Year: 2019 PMID： 31233386 DOI： 10.1161/STROKEAHA.118.023316
Source DB: PubMed Journal: Stroke ISSN： 0039-2499 Impact factor: 7.914