Aplicación del «Hat Score» para predecir el riesgo de sangrado cerebral y pronóstico posterior a trombólisis en acv isquémico agudo

Introduction

Intravenous thrombolysis is a proven effective therapy for the treatment of ischemic stroke. Its most feared complication is intracranial hemorrhage (ICH).

Objetive

To evaluate the usefulness of the «HAT Score» for estimating the risk of ICH, symptomatic ICH (sICH), hemorrhage with final fatal outcome (HFFO) and 90-day prognosis in patients with ischemic stroke who received intravenous thrombolytic therapy (TT).

Materials and methods

The «HAT Score» was applied to all patients over 18 years old with ischemic stroke who received TT, between 01/01/2003 and 05/01/2022. We evaluated the predictive capacity of this scale with receiver operator curve (ROC). We estimated the correlation between the «HAT Score» values and the modified Rankin scale (mRS) at 90 days.

Results

The «HAT Score» was applied to 92 patients. Median age was 75 years old (CI: 62; CS: 82) and 51.09% were women. We observed a ROC curve performance with a cutoff ≥3 points in «HAT Score» of 0.76 (95% CI, 0.64-0.88) for the prediction of ICH, of 0.74 (95% CI, 0.54-0.93) for sICH and 0.93 (95% CI, 0.83-1) for HFFO. The «HAT Score» represented 25.25% of the variability explained in the mRS scale at 90 days.

Conclusion

In our population, the «HAT Score» adequately predict the rate of any ICH and 90-day prognosis. It is a useful tool to identify patients who would be at higher risk and eventually discourage thrombolysis.