Risk factors for intracerebral hemorrhage after treatment with recombinant tissue-type plasminogen activator for acute ischemic stroke
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 397 - 400
DOI: https://doi.org/10.5372/1905-7415.0903.409
Keywords
© 2015 Warinthorn Phuttharak, Kittisak Sawanyawisuth, Boonrerk Sangpetngam, Somsak Tiamkao, Kannikar Kongbunkiat, Verajit Chotmongkol, Panita Limpawattana, Theerayut Thongkrau, Chaiyapon Keeratikasikorn
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Acute stroke is a common neurological disorder. Intravenous recombinant tissue-type plasminogen activator (rt-PA) treatment is recommended for treatment of patients with acute ischemic stroke. A major side effect of rt-PA is intracerebral hemorrhage (ICH). Studies of the risks for ICH after rt-PA treatment in Asian populations are limited.
Objective
To determine risk factors for intracerebral hemorrhage after treatment of acute ischemic stroke with rt-PA and create online tool to calculate the risk.
Methods
We reviewed all patients with acute ischemic stroke who received treatment with rt-PA within 4.5 hours of stroke onset at the stroke fast track unit, Srinagarind Hospital, Khon Kaen University, Thailand. The study period was between November 2008 and September 2011. Factors associated with ICH after rt-PA treatment were analyzed by multivariate logistic regression.
Results
There were 162 patients with acute ischemic stroke who received rt-PA treatment within 4.5 hours. Of those, 12 patients (7.41%) developed ICH. Only baseline modified Rankin scale score was significantly associated with ICH. The adjusted odds ratio was 1.733 (95% CI 1.008 to 2.982). An online tool to calculate the risk is available at
Conclusions
Intracerebral hemorrhage after rt-PA treatment of patients with acute stroke was low at 7.41% and related to baseline functional status.