Symptomatic intracranial hemorrhage after stroke thrombolysis: The SEDAN Score

• DOI: 10.1002/ana.23546
• Publication Date: 2012-02-01T15:29:46Z
• Authors: Daniel Strbian; Stefan Engelter; Patrik Michel; Atte Meretoja; Lucka Sekoranja; Frank J. Ahlhelm; Satu Mustanoja; Igor Kuzmanovic; Tiina Sairanen; Nina Forss; Maria Cordier; Philippe Lyrer; Markku Kaste; Turgut Tatlisumak
• Keywords: Stroke

A study was undertaken to develop a score for assessing risk symptomatic intracranial hemorrhage (sICH) in ischemic stroke patients treated with intravenous (IV) thrombolysis.The derivation cohort comprised 974 (1995-2008) IV thrombolysis at the Helsinki University Central Hospital. The predictive value of parameters associated sICH (European Cooperative Acute Stroke Study II) evaluated, and we developed our according magnitude logistic regression coefficients. We calculated absolute risks likelihood ratios per increasing points. validated 828 from 3 Swiss cohorts (Lausanne, Basel, Geneva). Performance tested area under receiver operating characteristic curve (AUC-ROC).Our SEDAN (0 6 points) comprises baseline blood Sugar (glucose; 8.1-12.0 mmol/l [145-216 mg/dl] = 1; >12.0 [>216 2), Early infarct signs (yes 1) (hyper)Dense cerebral artery sign on admission computed tomography scan, Age (>75 years 1), NIH Scale (≥10 1). Absolute was: 1.4%, 2.9%, 8.5%, 12.2%, 21.7%, 33.3% 0, 1, 2, 3, 4, 5 points, respectively. In validation cohort, were similar (1.0%, 3.5%, 5.1%, 9.2%, 16.9%, 27.8%, respectively). AUC-ROC 0.77 (0.71-0.83; p < 0.001).Our reliably assessed thrombolysis-treated anterior- posterior circulation stroke, it can support clinical decision making high-risk patients. External supports its generalization.