Risk factors of spontaneous hemorrhagic transformation after cerebral infarction

Abstract

Objective To investigate the risk factors of spontaneous hemorrhagic transformation after cerebral infarction.Methods The clinical and imaging data of 151 patients with cerebral infarction without thrombolytic therapy were analyzed retrospectively.According to the intracranial hemorrhage under hospital CT scan or MRI,these patients were divided into hemorrhagic transformation (HT) group (n=16) and non-HT group (n=135).Influencing factors were analyzed by stepwise logistic regression.The receiver operating characteristic (ROC) curve analysis on the independent risk factors was performed to obtain the optimum predictive value of spontaneous hemorrhagic transformation.Results Admission blood glucose,pulse pressure and high sensitivity C-reactive protein levels were statistically significant between HT and non-HT groups (P ＜0.05).Multivariate logistic regression analysis demonstrated that admission blood glucose (OR:1.274,95％CI:1.093-1.485),pulse pressure (OR:1.208,95％ CI:1.005-1.051) were independent predictors of spontaneous hemorrhagic transformation in ischemic stroke without thrombolytic therapy.The ROC curve showed that when random blood glucose after admission was 5.575 mmol/L and pulse pressure was 35 mm Hg,the optimum prediction effect could be achieved.Conclusion When an ischemic stroke patient has high levels of blood glucose and pulse pressure on admission,he should be alert the occurrence of HT. Key words: Cerebral infarction; Spontaneous hemorrhagic transformation; Risk factor