Predictive Power of Hemorrhagic Transformation Scores in Real Life Stroke Patients Undergone to Urgent Reperfusion: A Brief Report

Introduction and aim: Hemorrhagic transformation (HT) is the most feared complication in acute phase of ischemic stroke. Predicting HT is of utmost importance in clinical practice. In the latest years a lot of HT prediction scores have been proposed, but their comparison in real life lack. Therefore, the aim of our study was to provide information about this topic. Materials and Methods: We retrospectively calculated THRIVE, SPAN-100, MSS score, SITS-ICH and GRASPS scores in patients consecutively admitted in our Stroke Unit along two years. To evaluate their predictive power, the area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve was calculated. Results: Study population was composed by ninety-one patients (51.6% females) with mean age 80.1 ± 11.3 years. Seventy-four (81.3%) patients undergone to systemic intravenous alteplase, seven (7.7%) to mechanical thrombectomy, ten (11%) to systemic intravenous alteplase plus mechanical thrombectomy. Eighteen patients (19.7%) presented HT. MSS score was the best prognosticator of HT, however the predictive power of the five analyzed score was low, ranging from and none of the score resulted significantly superior to the others. Conclusion: Our real-life study showed a low predictive power of a lot of HT prediction scores. Further prospective studies are warranted.