IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

被引：62

作者：

Cappellari, Manuel ^{[2
]}

Mangiafico, Salvatore ^{[3
]}

Saia, Valentina ^{[6
]}

Pracucci, Giovanni ^{[4
,7
]}

Nappini, Sergio ^{[3
]}

Nencini, Patrizia ^{[4
,7
]}

Konda, Daniel ^{[8
]}

Sallustio, Fabrizio ^{[9
]}

Vallone, Stefano ^{[10
]}

Zini, Andrea ^{[11
]}

Bracco, Sandra ^{[12
]}

Tassi, Rossana ^{[13
]}

Bergui, Mauro ^{[14
]}

Cerrato, Paolo ^{[15
]}

Pitrone, Antonio ^{[16
]}

Grillo, Francesco ^{[17
]}

Saletti, Andrea ^{[18
]}

De Vito, Alessandro ^{[19
]}

Gasparotti, Roberto ^{[20
]}

Magoni, Mauro ^{[21
]}

Puglielli, Edoardo ^{[22
]}

Casalena, Alfonsina ^{[23
]}

Causin, Francesco ^{[24
]}

Baracchini, Claudio ^{[25
]}

Castellan, Lucio ^{[26
]}

Malfatto, Laura ^{[27
]}

Menozzi, Roberto ^{[28
]}

Scoditti, Umberto ^{[29
]}

Comelli, Chiara ^{[30
]}

Duc, Enrica ^{[31
]}

Comai, Alessio ^{[32
]}

Franchini, Enrica ^{[33
]}

Cosottini, Mirco ^{[34
]}

Mancuso, Michelangelo ^{[35
]}

Peschillo, Simone ^{[36
]}

De Michele, Manuela ^{[37
]}

Giorgianni, Andrea ^{[38
]}

Delodovici, Maria Luisa ^{[39
]}

Lafe, Elvis ^{[40
]}

Denaro, Maria Federica ^{[41
]}

Burdi, Nicola ^{[42
]}

Interno, Saverio ^{[43
]}

Cavasin, Nicola ^{[44
]}

Critelli, Adriana ^{[45
]}

Chiumarulo, Luigi ^{[47
]}

Petruzzellis, Marco ^{[46
]}

Doddi, Marco ^{[48
]}

Carolei, Antonio ^{[49
]}

Auteri, William ^{[50
]}

Petrone, Alfredo ^{[51
]}

机构：

[1] Azienda Osped Univ Integrata, Neuroradiol Unit, Verona, Italy

[2] Azienda Osped Univ Integrata, Stroke Unit, Verona, Italy

[3] Osped Careggi Univ Hosp, Intervent Neuroradiol Unit, Florence, Italy

[4] Osped Careggi Univ Hosp, Stroke Unit, Florence, Italy

[5] Santa Corona Hosp, Neuroradiol Unit, Pietra Ligure, Italy

[6] Santa Corona Hosp, Neurol & Stroke Unit, Pietra Ligure, Italy

[7] Univ Florence, Florence, Italy

[8] Policlin Tor Vergata, Intervent Neuroradiol Unit, Rome, Italy

[9] Policlin Tor Vergata, Stroke Unit, Rome, Italy

[10] Osped Civile S Agostino Estense Univ Hosp, Neuroradiol Unit, Modena, Italy

[11] Maggiore Hosp, Stroke Unit, IRCCS Ist Sci Neurol, Bologna, Italy

[12] Osped S Maria delle Scotte Univ Hosp, Intervent Neuroradiol Unit, Siena, Italy

[13] Osped S Maria delle Scotte Univ Hosp, Stroke Unit, Siena, Italy

[14] Citta Salute & Sci Molinette, Intervent Neuroradiol Unit, Turin, Italy

[15] Citta Salute & Sci Molinette, Stroke Unit, Turin, Italy

[16] Policlin G Martino, Intervent Neuroradiol Unit, Messina, Italy

[17] Policlin G Martino, Stroke Unit, Messina, Italy

[18] Arcispedale S Anna Univ Hosp, Intervent Neuroradiol Unit, Ferrara, Italy

[19] Arcispedale S Anna Univ Hosp, Stroke Unit, Ferrara, Italy

[20] Spedali Civil Brescia, Neuroradiol Unit, Brescia, Italy

[21] Spedali Civil Brescia, Stroke Unit, Brescia, Italy

[22] Osped Civile Mazzini, Vasc & Intervent Radiol Unit, Teramo, Italy

[23] Osped Civile Mazzini, Neurol Unit, Teramo, Italy

[24] Azienda Osped Univ, Neuroradiol Unit, Padua, Italy

[25] Azienda Osped Univ, Stroke Unit, Padua, Italy

[26] IRCCS San Martino IST, Intervent Neuroradiol Unit, Genoa, Italy

[27] IRCCS San Martino IST, Stroke Unit, Genoa, Italy

[28] Osped Univ, Intervent Neuroradiol Unit, Parma, Italy

[29] Osped Univ, Stroke Unit, Parma, Italy

[30] Osped San Giovanni Bosco, Intervent Neuroradiol Unit, Turin, Italy

[31] Osped San Giovanni Bosco, Neurol Unit, Turin, Italy

[32] Osped Cent, Radiol Unit, Bolzano, Italy

[33] Osped Cent, Stroke Unit, Bolzano, Italy

[34] Osped Cisanello, Neuroradiol Unit, Pisa, Italy

[35] Osped Cisanello, Neurol Unit, Pisa, Italy

[36] Sapienza Univ Hosp, Intervent Neuroradiol Unit, Rome, Italy

[37] Sapienza Univ Hosp, Stroke Unit, Rome, Italy

[38] Osped Univ Circolo, ASST Sette Laghi, Neuroradiol Unit, Varese, Italy

[39] Osped Univ Circolo, ASST Sette Laghi, Stroke Unit, Varese, Italy

[40] San Matteo Hosp, Diagnost & Intervent Neuroradiol Unit, Pavia, Italy

[41] San Matteo Hosp, Stroke Unit, Pavia, Italy

[42] Osped SS Annunziata, Intervent Radiol Unit, Taranto, Italy

[43] Osped SS Annunziata, Stroke Unit, Taranto, Italy

[44] Osped Angelo, Neuroradiol Unit, USSL3 Serenissima, Venice, Italy

[45] Osped Angelo, Neurol Unit, USSL3 Serenissima, Venice, Italy

[46] Policlin Bari, Intervent Neuroradiol Unit, Bari, Italy

[47] Policlin Bari, Stroke Unit, Bari, Italy

[48] Presidio Osped SS Filippo & Nicola, Intervent Neuroradiol Unit, Avezzano, Italy

[49] Presidio Osped SS Filippo & Nicola, Stroke Unit, Avezzano, Italy

[50] Azienda Osped Annunziata, Intervent Neuroradiol Unit, Cosenza, Italy

来源：

STROKE | 2019年 / 50卷 / 04期

关键词：

contraindications; logistic models; nomograms; standard of care; thrombectomy; ACUTE ISCHEMIC-STROKE; INTRAVENOUS THROMBOLYSIS; ENDOVASCULAR TREATMENT; OUTCOMES; CIRCULATION; VALIDATION; PERFUSION; THERAPY; TRIAL;

D O I：

10.1161/STROKEAHA.118.023316

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods-We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of >= 4 National Institutes of Health Stroke Scale score points from baseline <= 24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results-National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions-The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

引用

页码：909 / 916

页数：8

共 25 条

[1] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Berkhemer, O. A.
Fransen, P. S. S.
Beumer, D.
van den Berg, L. A.
Lingsma, H. F.
Yoo, A. J.
Schonewille, W. J.
Vos, J. A.
Nederkoorn, P. J.
Wermer, M. J. H.
van Walderveen, M. A. A.
Staals, J.
Hofmeijer, J.
van Oostayen, J. A.
Nijeholt, G. J. Lycklama A.
Boiten, J.
Brouwer, P. A.
Emmer, B. J.
de Bruijn, S. F.
van Dijk, L. C.
Kappelle, L. J.
Lo, R. H.
Van Dijk, E. J.
de Vries, J.
de Kort, P. L. M.
van Rooij, W. J. J.
van den Berg, J. S. P.
van Hasselt, B. A. A. M.
Aerden, L. A. M.
Dallinga, R. J.
Visser, M. C.
Bot, J. C. J.
Vroomen, P. C.
Eshghi, O.
Schreuder, T. H. C. M. L.
Heijboer, R. J. J.
Keizer, K.
Tielbeek, A. V.
den Hertog, H. M.
Gerrits, D. G.
van den Berg-Vos, R. M.
Karas, G. B.
Steyerberg, E. W.
Flach, H. Z.
Marquering, H. A.
Sprengers, M. E. S.
Jenniskens, S. F. M.
Beenen, L. F. M.
van den Berg, R.
Koudstaal, P. J.
[J]. NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) : 11 - 20
[2] Development and external validation of two nomograms to predict overall survival and occurrence of distant metastases in adults after surgical resection of localised soft-tissue sarcomas of the extremities: a retrospective analysis
Callegaro, Dario
Miceli, Rosalba
Bonvalot, Sylvie
Ferguson, Peter
Strauss, Dirk C.
Levy, Antonin
Griffin, Anthony
Hayes, Andrew J.
Stacchiotti, Silvia
Le Pechoux, Cecile
Smith, Myles J.
Fiore, Marco
Dei Tos, Angelo P.
Smith, Henry G.
Mariani, Luigi
Wunder, Jay S.
Pollock, Raphael E.
Casali, Paolo G.
Gronchi, Alessandro
[J]. LANCET ONCOLOGY, 2016, 17 (05) : 671 - 680
[3] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection
Campbell, B. C. V.
Mitchell, P. J.
Kleinig, T. J.
Dewey, H. M.
Churilov, L.
Yassi, N.
Yan, B.
Dowling, R. J.
Parsons, M. W.
Oxley, T. J.
Wu, T. Y.
Brooks, M.
Simpson, M. A.
Miteff, F.
Levi, C. R.
Krause, M.
Harrington, T. J.
Faulder, K. C.
Steinfort, B. S.
Priglinger, M.
Ang, T.
Scroop, R.
Barber, P. A.
McGuinness, B.
Wijeratne, T.
Phan, T. G.
Chong, W.
Chandra, R. V.
Bladin, C. F.
Badve, M.
Rice, H.
de Villiers, L.
Ma, H.
Desmond, P. M.
Donnan, G. A.
Davis, S. M.
[J]. NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) : 1009 - 1018
[4] STARTING-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Intravenous Thrombolysis for Stroke
Cappellari, Manuel
Turcato, Gianni
Forlivesi, Stefano
Zivelonghi, Cecilia
Bovi, Paolo
Bonetti, Bruno
Toni, Danilo
[J]. STROKE, 2018, 49 (02) : 397 - 404
[5] CT perfusion and angiographic assessment of pial collateral reperfusion in acute ischemic stroke: the CAPRI study
Consoli, Arturo
Andersson, Tommy
Holmberg, Ake
Verganti, Luca
Saletti, Andrea
Vallone, Stefano
Zini, Andrea
Cerase, Alfonso
Romano, Daniele
Bracco, Sandra
Lorenzano, Svetlana
Fainardi, Enrico
Mangiafico, Salvatore
[J]. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2016, 8 (12) : 1211 - +
[6] How many stroke patients might be eligible for mechanical thrombectomy?
El Tawil, Salwa
Cheripelli, Bharath
Huang, Xuya
Moreton, Fiona
Kalladka, Dheeraj
MacDougal, Niall J. J.
McVerry, Ferghal
Muir, Keith W.
[J]. EUROPEAN STROKE JOURNAL, 2016, 1 (04) : 264 - 271
[7] Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke
Goyal, M.
Demchuk, A. M.
Menon, B. K.
Eesa, M.
Rempel, J. L.
Thornton, J.
Roy, D.
Jovin, T. G.
Willinsky, R. A.
Sapkota, B. L.
Dowlatshahi, D.
Frei, D. F.
Kamal, N. R.
Montanera, W. J.
Poppe, A. Y.
Ryckborst, K. J.
Silver, F. L.
Shuaib, A.
Tampieri, D.
Williams, D.
Bang, O. Y.
Baxter, B. W.
Burns, P. A.
Choe, H.
Heo, J. -H.
Holmstedt, C. A.
Jankowitz, B.
Kelly, M.
Linares, G.
Mandzia, J. L.
Shankar, J.
Sohn, S. -I.
Swartz, R. H.
Barber, P. A.
Coutts, S. B.
Smith, E. E.
Morrish, W. F.
Weill, A.
Subramaniam, S.
Mitha, A. P.
Wong, J. H.
Lowerison, M. W.
Sajobi, T. T.
Hill, M. D.
[J]. NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) : 1019 - 1030
[8] Predictors for Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Acute Ischemic Stroke
Hao, Yonggang
Yang, Dong
Wang, Huaiming
Zi, Wenjie
Zhang, Meng
Geng, Yu
Zhou, Zhiming
Wang, Wei
Xu, Haowen
Tian, Xiguang
Lv, Penghua
Liu, Yuxiu
Xiong, Yunyun
Liu, Xinfeng
Xu, Gelin
[J]. STROKE, 2017, 48 (05) : 1203 - +
[9] Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke
Higashida, RT
Furlan, AJ
[J]. STROKE, 2003, 34 (08) : E109 - E137
[10] The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study
Hijazi, Ziad
Oldgren, Jonas
Lindback, Johan
Alexander, John H.
Connolly, Stuart J.
Eikelboom, John W.
Ezekowitz, Michael D.
Held, Claes
Hylek, Elaine M.
Lopes, Renato D.
Siegbahn, Agneta
Yusuf, Salim
Granger, Christopher B.
Wallentin, Lars
[J]. LANCET, 2016, 387 (10035) : 2302 - 2311

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