TURN Score Predicts 24-Hour Cerebral Edema After IV Thrombolysis

Neurocritical Care
David AsuzuKevin N Sheth

Abstract

Cerebral edema is associated with poor outcome after IV thrombolysis. We recently described the TURN score (Thrombolysis risk Using mRS and NIHSS), a predictor of severe outcome after IV thrombolysis. Our purpose was to evaluate its ability to predict 24-h cerebral edema. We retrospectively analyzed data from 303 patients who received IV rt-PA during the NINDS rt-PA trial. Measures of brain swelling included edema, mass effect and midline shift assessed at baseline, at 24 h and new onset at 24 h. Outcome was assessed using intracerebral hemorrhage (ICH), symptomatic intracerebral hemorrhage (sICH), 90-day severe outcome, and 90-day mortality. Statistical associations were assessed by logistic regression reporting odds ratios (OR) and by areas under the receiver operating characteristic curves (AUROC). Baseline brain swelling did not predict poor outcome; however, 24-h brain swelling predicted ICH (OR 5.69, P < 0.001), sICH (OR 9.50, P = 0.01), 90-day severe outcome (OR 7.10, P < 0.001), and 90-day mortality (OR 5.65, P = 0.01). Similar results were seen for new brain swelling at 24 h. TURN predicted 24-hour brain swelling (OR 2.5, P < 0.001; AUROC 0.69, 95 % CI 0.63-0.75) and new brain swelling at 24 h (OR 2.1, P < 0.001; AUROC...Continue Reading

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Citations

Sep 25, 2019·Neurocritical Care·W Taylor Kimberly
Dec 8, 2019·Translational Stroke Research·Samantha E SpellicySteven L Stice
May 11, 2017·Stroke; a Journal of Cerebral Circulation·Charlene Jennifer OngJin-Moo Lee
Dec 16, 2020·Stroke; a Journal of Cerebral Circulation·Laura HeitschUNKNOWN International Stroke Genetics Consortium

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