Factors affecting Intracerebral Hemorrhage following Intravenous Thrombolysis in Patients with Acute Ischemic Stroke

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สุจริต สวนกูล
ธานินทร์ โลเกศกระวี


Background: There is limited information about risk factors of intracerebral hemorrhage (ICH) in patients treated with intravenous recombinant tissue plasminogen activator (IVrt-PA) for stroke fast track program in Thailand.
Objective: To determine factors associated with ICH following IVrtPA in stroke fast track program in Lampang Hospital.
Material and method: Retrospective cohort study was conducted on 391 patients with acute ischemic stroke whom treated with IVrt-PA at emergency department of Lampang Hospital between June 2008 - September 2016. Baseline characteristics, laboratory tests, findings of brain CT scan images were recorded. Risk factors were compared between patients without ICH, asymptomatic ICH and symptomatic ICH by using ordinal logistic regression analysis.
Results : The incidence of ICH was 18.4% (asymptomatic ICH 11.2%, symptomatic ICH 7.2%). Risk factors for ICH were male (RR1.88, 95%CI 1.12-3.16, p=0.017), DM with prior stroke (RR 4.64, 95%CI 1.23-17.50, p=0.023), increasing NIHSS scores (NIHSS 10-20: RR 1.87, 1.00-3.49, p=0.049; NIHSS>20: RR 2.96, 95% CI 1.26-6.95, p=0.013) and systolic blood pressure prior thrombolysis ≥150 mmHg (RR 2.09, 95% CI 1.26-6.95, p=0.004).
Conclusion: Male, DM with prior stroke, severe stroke symptoms and high systolic blood pressure prior thrombolysis were risk factors for ICH among patients with acute ischemic stroke treated with IVrt-PA.


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สวนกูล ส., & โลเกศกระวี ธ. (2016). Factors affecting Intracerebral Hemorrhage following Intravenous Thrombolysis in Patients with Acute Ischemic Stroke. Lampang Medical Journal, 37(2), 67–77. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/185880
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