Predicting post‐thrombolysis intracerebral hemorrhage: A systematic review

Abstract ObjectivesFear of intracerebral hemorrhage (ICH) is a deterrent to the uptake of thrombolytic therapy, an evidence‐based treatment for acute ischemic stroke. Several characteristics associated with post‐thrombolysis ICH have been identified, but their combined utility for risk stratification has yet to be clarified. We critically examined risk models to predict post‐thrombolysis ICH, and evaluated their potential clinical utility. MethodsMEDLINE (Inception to October 2012) was searched and bibliographies of retrieved articles examined. Inclusion and exclusion criteria of each study were reviewed. Eligible studies had to report on the development, validation or impact assessment of a model constructed to predict the occurrence of ICH after thrombolysis for ischemic stroke. ResultsWe identified 10 publications reporting on 13 post‐thrombolysis ICH risk models, each developed from logistic regression. The number of participants/outcomes/predictors per model ranged from 89/45/4 to 27,804/558/7; age, glycaemia, and the NIH stroke scale score were common predictors. Models had modest‐to‐acceptable discriminatory ability (c‐statistic ranging from 0.59 to 0.88) in the derivation sample and during external validation (conducted for three models). Calibration was acceptable in the three studies where it was assessed. Impact studies to evaluate the effect of adopting ICH risk models on clinical outcomes have not yet been conducted.© 2013 International Society on ...
Source: Journal of Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Original Article ‐ Clinical Haemostasis and Thrombosis Source Type: research