Risk factors and predictive model of hemorrhage transformation after thrombolysis in cerebral infarction
10.3760/cma.j.issn.1008-1372.2019.04.014
- VernacularTitle:急性脑梗死静脉溶栓后继发出血转化的危险因素及预测模型分析
- Author:
Cailing WANG
1
;
Juan FENG
Author Information
1. 中国医科大学附属盛京医院神经内科
- Keywords:
Brain infarction;
Thrombolytic therapy;
Injections,intravenous;
Cerebral hemorrhage;
Models,statistical;
Factor analysis,statistical
- From:
Journal of Chinese Physician
2019;21(4):540-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aims to explore the risk factors of hemorrhagic transformation (HT),and compare the predictive ability of different predictive models.Methods Retrospective analysis of clinical data of patients with intravenous thrombolysis in our hospital from June 2015 to June 2018.The risk factors were statistically analyzed.The results were fitted into a new predictive model named MODEL.The area under receiver operating characteristic (ROC) curve was used to compare the predictive ability of the MODEL and some traditional methods including the Multicenter Stroke Survey (MSS),and the Totaled Health Risks In Vascular Events Score (THRIVE),and the Glucose at presentation,Race,Age,Sex,systolic blood Pressure at presentation,Severity of stroke at presentation (GRASPS) to HT.Results The results of single factor analysis showed that there were significant differences in the history of hypertension,the history of atrial fibrillation,the systolic pressure before thrombolysis,the National Institute of Health Stroke Scale (NIHSS) score before thrombolysis,the level of plasma total cholesterol (TG),low density lipoprotein cholesterol (LDL-C),apolipoprotein B (Apo B),D dimer (DD),and the platelet distribution width and the sodium ion.Multivariate logistic regression analysis confirmed that the NIHSS score before thrombolysis,the level of plasma LDL-C and DD were independent risk factors for HT.The formation of a new predictive model was logi(p) =0.21 +0.99 × NIHSSscore-0.834 × LDL-C +0.002 × DD,which was defined as predictive mode of MODEL.The four predictive models all had predictive effects on HT.Z test results showed that,compared with the GRASPS,the MODEL and MSS showed a higher predictive power.Conclusions The NIHSS score before thrombolysis,and the level of plasma LDL-C,and DD were independent risk factors for HT after intravenous thrombolysis.MODEL and MSS had better predictive performance.
