A Risk Score to Predict Intracranial Hemorrhage After Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke

Abstract

Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited. Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each of 4 variables: age older than 60 years, baseline National Institutes of Health Stroke Scale score greater than 10, glucose greater than 8.325 mmol/L, and platelet count less than 150,000/mm(3). Rate of any ICH increased with higher scores: 0 points, 2.6%; 1 point, 9.7%; 2 points, 15.1%; and greater than or equal to 3 points, 37.9%. The model had reasonable discriminatory capability (C-statistic 0.69). A similar pattern was seen with symptomatic and asymptomatic ICH separately, and with radiographically defined parenchymal hemorrhage. A simple risk score may be useful for predicting postthrombolysis ICH.