A MULTICENTER STUDY ON EARLY HEMORRHAGIC TRANSFORMATION IN ISCHEMIC STROKE: PRELIMINARY RESULTS
Abstract number: O-M-034
Paciaroni1 M., Silvestrelli2 G., Ageno3 W., Alberti1 A., Lanari2 A., Caso1 V., Bertolani2 L., Venti1 M., Palmerini1 F., Billeci1 A., Biagini1 S., Previdi2 P., Agnelli1 G.
11Internal Medicine, University of Perugia, Perugia 22Neurology, C. Poma Hospital, Mantova 33Clinical Medicine, University of Insubria, Varese, Italy
How-to-cite Paciaroni M, Silvestrelli G, Ageno W, Alberti A, Lanari A, Caso V, Bertolani L, Venti M, Palmerini F, Billeci A, Biagini S, Previdi P, Agnelli G. A MULTICENTER STUDY ON EARLY HEMORRHAGIC TRANSFORMATION IN ISCHEMIC STROKE: PRELIMINARY RESULTS. J Thromb Haemost 2007; 5 Supplement 2: O-M-034
Introduction: Hemorrhagic transformation (HT) is a complication of acute stroke and it can make its functional outcome worse. The aims of this study were to assess: 1) the frequency of early HT in patients admitted for ischemic stroke 2) the predictive factors for HT 3) whether the presence of HT was correlated to functional outcome at discharge.
Methods: Among 729 consecutive patients (mean age 73.3 years 12.7) included in this multicenter study, 61 (8.4%) had HT on CT scan performed on day 5 (2) after stroke onset. Patients were studied for vascular risk factors, antithrombotic treatment before and during hospitalization, size of the lesion, stroke severity (NIHSS on admission), etiology of stroke, blood pressure, cholesterol and glycemia on admission.
Results: In the multivariate analysis, HT was predicted by stroke severity (OR 1.13, 95% CI 1.07-1.20, p<0.0001) and high systolic blood pressure on admission (OR 1.02, 95% CI 1.00-1.04, p=0.047). At discharge, 322 patients (44.2%) were disabled (mRS>=3) or died. In the multivariate analysis HT (OR 10.43, 95% CI 2.22-48.92, p=0.003), stroke severity (OR 1.73, 95% CI 1.54-1.96, p<0.0001), diabetes mellitus (OR 2.31, 95% CI 1.06-5.01, p=0.035), stroke recurrence (OR 1.42, 95% CI 1.21-1.84, p=0.014) and age (OR 1.09, 95% CI 1.05-1.12, p<0.0001) were independent predictors for mortality or disability. Treatment with rt-PA was independent predictor for good outcome (OR 0.25, 95% CI 0.06-1.00, p=0.05).
Conclusions: Early HT was present in about 9% of patients and it was predicted by stroke severity and high systolic blood pressure on admission. Early HT seems to determine an adverse short-term outcome.