Risk factors of hemorrhage transformation after ischemic stroke and its prediction model

Abstract

Objective To establish a prediction model by analyzing the related risk factors of hemorrhage transformation (HT) after ischemic stroke. Methods A retrospective study was performed on 327 cases of patients with ischemic stroke who were admitted from January 2015 to September 2016.The pathogenesis,clinical manifestation and general data of patients were retrospectively analyzed.The risk factors of HT were selected by logistic regression analysis and other methods,a new prediction model was established,and the evaluation boundary value of the ROC curve was obtained,which was greater than the evaluation boundary value was in HT high risk group. Results Atrial fibrillation ( OR=4.940,95%CI: 1.879~12.988,P<0.05 ),systolic blood pressure higher than 160 mmHg ( OR=2.762,95%CI: 1.175~6.494,P<0.05,1 mmHg=0.133 kPa ),massive cerebral infarction ( OR=3.796,95%CI: 1.495~9.635,P<0.05),NIHSS score more than 10 points ( OR=5.665,95%CI: 2.289~14.021,P<0.05),thrombolytic treatment ( OR=3.086,95%CI: 4.981~96.257,P<0.05) were independent risk factors for HT.Prediction model: Logit P=-3.588+ 1.579×X1+ 1.016×X2+ 1.334×X3+ 1.734×X4+ 3.086×X5.The AUC was 0.912 (95%CI: 0.873~0.950,P<0.001). When the boundary value was-2,the sensitivity was 88.33%,specificity is 82.02%. Conclusion Atrial fibrillation history,systolic blood pressure which is higher than 160 mmHg,massive cerebral infarction,NIHSS score is more than 10 point,and thrombolytic treatment are independent risk factors for HT.The patient will have a higher risk of HT,when the boundary value is greater than-2. Key words: Ischemic stroke; Hemorrhage transformation; Risk factor; Prediction model