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

被引：67

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

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