Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator
Background: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). Objective: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. Material and Metho...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=3;spage=214;epage=219;aulast=Chenna |
| _version_ | 1818262963633520640 |
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| author | Vijay Chenna Subhash Kaul Swetha Tandra Sireesha Yareeda Neeharika Mathukumalli Abhijeet Kumar Kohat Rukmini Mridula Kandadai Suryaprabha Turaga Jabeen Afshan Sheik A K Meena Rupam Borgohain |
| author_facet | Vijay Chenna Subhash Kaul Swetha Tandra Sireesha Yareeda Neeharika Mathukumalli Abhijeet Kumar Kohat Rukmini Mridula Kandadai Suryaprabha Turaga Jabeen Afshan Sheik A K Meena Rupam Borgohain |
| author_sort | Vijay Chenna |
| collection | DOAJ |
| description | Background: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). Objective: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. Material and Methods: Consecutive patients of AIS thrombolysed between January 2010 and June 2016 in a University hospital in Hyderabad (India) were studied prospectively for sICH and it's various variables compared with the control group without sICH to determine any sigificantant difference. Results: Out of 113 patients , sICH was detected in 12 (10.61%) whose mean age(58±12.0 years) and gender ratio ( 2:1 ) was not statistically significant from controls. In s ICH group mean NIHSS score was 16.53± 5.81 vs 10.19± 5.06 in controls (p<0.001), gap between stroke onset and thrombolysis was 227.50±46.15 min vs 178.50± 69.20 min in controls(p=0.018).At presentation mean blood sugar was 208.75±90.97 mg/dl in sICH group vs 146.83±70.21 mg/dl in controls (p=0.002). Prior diabetes was in 7(53.30%) vs 23 (22.8%) in controls (p= 0.014)and hypertension in 11 (91.7%) vs (56(55.4%) in controls (p= 0.026) The mortality in sICH was 7 (58.30%)vs 4 (4.94%) in controls (p<.0.001). At 3 months mean mRS ofsICH patients was 5.57± 0.54 vs 2.17± 1.69 in controls (p<.05). Conclusion: High NIHSS score, increased stroke onset to thrombolysis time , high blood sugar at presentation ,prior diabetes and hypertension increase the chances of sICH. None of these contraindicate thrombolysing strokes but should caution the physician. |
| first_indexed | 2024-12-12T19:11:28Z |
| format | Article |
| id | doaj.art-8cd86a9ffaeb4ed480d8d5fc9fd59ce2 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-12T19:11:28Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-8cd86a9ffaeb4ed480d8d5fc9fd59ce22022-12-22T00:14:51ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492018-01-0121321421910.4103/aian.AIAN_228_17Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activatorVijay ChennaSubhash KaulSwetha TandraSireesha YareedaNeeharika MathukumalliAbhijeet Kumar KohatRukmini Mridula KandadaiSuryaprabha TuragaJabeen Afshan SheikA K MeenaRupam BorgohainBackground: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). Objective: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. Material and Methods: Consecutive patients of AIS thrombolysed between January 2010 and June 2016 in a University hospital in Hyderabad (India) were studied prospectively for sICH and it's various variables compared with the control group without sICH to determine any sigificantant difference. Results: Out of 113 patients , sICH was detected in 12 (10.61%) whose mean age(58±12.0 years) and gender ratio ( 2:1 ) was not statistically significant from controls. In s ICH group mean NIHSS score was 16.53± 5.81 vs 10.19± 5.06 in controls (p<0.001), gap between stroke onset and thrombolysis was 227.50±46.15 min vs 178.50± 69.20 min in controls(p=0.018).At presentation mean blood sugar was 208.75±90.97 mg/dl in sICH group vs 146.83±70.21 mg/dl in controls (p=0.002). Prior diabetes was in 7(53.30%) vs 23 (22.8%) in controls (p= 0.014)and hypertension in 11 (91.7%) vs (56(55.4%) in controls (p= 0.026) The mortality in sICH was 7 (58.30%)vs 4 (4.94%) in controls (p<.0.001). At 3 months mean mRS ofsICH patients was 5.57± 0.54 vs 2.17± 1.69 in controls (p<.05). Conclusion: High NIHSS score, increased stroke onset to thrombolysis time , high blood sugar at presentation ,prior diabetes and hypertension increase the chances of sICH. None of these contraindicate thrombolysing strokes but should caution the physician.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=3;spage=214;epage=219;aulast=ChennaIndiaintracerebral hemorrhagestrokethrombolysis |
| spellingShingle | Vijay Chenna Subhash Kaul Swetha Tandra Sireesha Yareeda Neeharika Mathukumalli Abhijeet Kumar Kohat Rukmini Mridula Kandadai Suryaprabha Turaga Jabeen Afshan Sheik A K Meena Rupam Borgohain Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator Annals of Indian Academy of Neurology India intracerebral hemorrhage stroke thrombolysis |
| title | Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| title_full | Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| title_fullStr | Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| title_full_unstemmed | Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| title_short | Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| title_sort | predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator |
| topic | India intracerebral hemorrhage stroke thrombolysis |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=3;spage=214;epage=219;aulast=Chenna |
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