Open AccessHemorrhagic transformation predictors in ischemic stroke patients from a Stroke Unit
Author(s) -
Fernanda Ferreira de Abreu,
Vinícius Bessa Mendez,
Ivã Taiuan Fialho Silva,
Alice Monteiro Soares Cajaíba,
Pedro Antônio Pereira de Jesus
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.659
Subject(s) - medicine , etiology , thrombolysis , atrial fibrillation , stroke (engine) , ischemic stroke , cohort , prospective cohort study , cardiology , risk factor , multivariate analysis , ischemia , myocardial infarction , mechanical engineering , engineering
Background: Hemorrhagic transformation (HT) is an aggravating factor to patients with ischemic stroke. For patients’ best care, it’s essential to know its predictors. Objective: To describe HT in patients with ischemic stroke. Design and setting: Prospective cohort with ischemic stroke patients from a Stroke Unit, admitted between 2017 to 2019. Methods: All patients performed a brain computer tomography (CT) scan on arrival and 24-hours later. Patients with or without HT were compared for predictors. Results: 363 patients were included, with a mean age of 63,14 (±13,92), 53,1% were male and 9,9% (n= 38) had HT. Thrombolysis didn’t increase the risk of HT [(55,3% vs 42,5%); p= 0,132]. Patients with atrial fibrillation [(31,6% vs 12,6%); p= 0,002], and cardioembolic etiology according with TOAST classification [(57,6% vs 21,7%); p< 0,001] had higher risk of HT. Patients with HT had lower ASPECTS scores on their initial CT [8 (6-9) vs 9 (8-10); p< 0,001] and higher NIHSS scores [12 (9-15) vs 8 (5-12); p< 0,001]. Cardioembolic strokes [OR= 4,67; (IC95% 2,01-10,84)] and higher NIHSS [OR= 1,11; (IC95% 1,01-1,22)] were independently associated with HT after multivariate adjustments, considering ASPECTS and thrombolysis. Conclusion: Cardioembolic etiology and higher NIHSS score were independently associated with HT. It’s essential to know HT predictors due to worse outcomes associated with its occurrence.