Predicting Hemorrhagic Transformation of Acute Ischemic Stroke: Prospective Validation of the HeRS Score

Medicine
Elisabeth B MarshRebecca F Gottesman

Abstract

Hemorrhagic transformation (HT) increases the morbidity and mortality of ischemic stroke. Anticoagulation is often indicated in patients with atrial fibrillation, low ejection fraction, or mechanical valves who are hospitalized with acute stroke, but increases the risk of HT. Risk quantification would be useful. Prior studies have investigated risk of systemic hemorrhage in anticoagulated patients, but none looked specifically at HT. In our previously published work, age, infarct volume, and estimated glomerular filtration rate (eGFR) significantly predicted HT. We created the hemorrhage risk stratification (HeRS) score based on regression coefficients in multivariable modeling and now determine its validity in a prospectively followed inpatient cohort.A total of 241 consecutive patients presenting to 2 academic stroke centers with acute ischemic stroke and an indication for anticoagulation over a 2.75-year period were included. Neuroimaging was evaluated for infarct volume and HT. Hemorrhages were classified as symptomatic versus asymptomatic, and by severity. HeRS scores were calculated for each patient and compared to actual hemorrhage status using receiver operating curve analysis.Area under the curve (AUC) comparing predic...Continue Reading

References

Jun 1, 1979·European Journal of Clinical Investigation·M J FordJ F Munro
Apr 1, 1991·Brain : a Journal of Neurology·C P HawkinsW I McDonald
Mar 1, 1986·Stroke; a Journal of Cerebral Circulation·C R HornigA L Agnoli
Nov 1, 1985·The American Journal of Medicine·G Di MinnoS Murphy
Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Nov 1, 1993·Kidney International·K IsekiK Fukiyama
Nov 1, 1996·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·M BrouillardD Pagniez
Oct 22, 2004·Seminars in Thrombosis and Hemostasis·Paola BoccardoMiriam Galbusera
Jan 20, 2007·Stroke; a Journal of Cerebral Circulation·Pooja KhatriJoseph P Broderick
Oct 27, 2007·Stroke; a Journal of Cerebral Circulation·Michiel J BosMonique M B Breteler
Oct 1, 2008·Neurology·M L FlahertyD Woo
Jan 10, 2009·Diabetes Care·Alexandre Y PoppeUNKNOWN Canadian Alteplase for Stroke Effectiveness Study Investigators
Mar 13, 2010·The American Journal of Emergency Medicine·W T LongstrethBruce M Psaty
Sep 30, 2010·Developmental Medicine and Child Neurology·Jonathan T KleinmanLori C Jordan
Sep 24, 2011·Stroke; a Journal of Cerebral Circulation·Yi Yang, Gary A Rosenberg
Aug 17, 2012·The New England Journal of Medicine·Jonas Bjerring OlesenChristian Torp-Pedersen
Sep 21, 2012·Neurology·Glen C Jickling, Bogdan N Manolescu
Mar 20, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Askiel BrunoUNKNOWN SHINE investigators
Mar 26, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·E B MarshR F Gottesman
May 9, 2014·Stroke; a Journal of Cerebral Circulation·Elisabeth B MarshRafael H Llinas

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Citations

Sep 19, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Xingyong ChenXu Zhang
Feb 23, 2020·Critical Care Nursing Quarterly·Natalie TuckerG Morgan Jones
Apr 27, 2018·Arkhiv patologii·I V SamorodskayaD Sh Vaisman
Mar 27, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Antonio MuscariMarco Zoli
Jul 9, 2020·Journal of Stroke·Basile KerlerouxUNKNOWN JENI Research Collaborative
Jan 29, 2017·Current Treatment Options in Neurology·Joshua A StoneShadi Yaghi
May 14, 2020·Arquivos de neuro-psiquiatria·João Brainer Clares de AndradeGisele Sampaio Silva
Oct 31, 2020·Cellular and Molecular Neurobiology·Chengli LiuWei Wang
Dec 21, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Xin WangLijuan Zhang
May 8, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Leonard Leong-Litt YeoBenjamin Yong-Qiang Tan
Jun 1, 2021·Frontiers in Neurology·Elena SpronkGlen C Jickling

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