IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

Listing of IER Collaborators

Research output: Contribution to journalArticle

Abstract

Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

Original languageEnglish
Pages (from-to)909-916
Number of pages8
JournalStroke
Volume50
Issue number4
DOIs
Publication statusPublished - Apr 2019

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Thrombectomy
Nomograms
Cerebral Hemorrhage
Stroke
ROC Curve
National Institutes of Health (U.S.)
Alberta
Registries
Cohort Studies
Logistic Models

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IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke. / Listing of IER Collaborators.

In: Stroke, Vol. 50, No. 4, 04.2019, p. 909-916.

Research output: Contribution to journalArticle

Listing of IER Collaborators. / IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke. In: Stroke. 2019 ; Vol. 50, No. 4. pp. 909-916.
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title = "IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke",
abstract = "Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.",
author = "{Listing of IER Collaborators} and Manuel Cappellari and Salvatore Mangiafico and Valentina Saia and Giovanni Pracucci and Sergio Nappini and Patrizia Nencini and Daniel Konda and Fabrizio Sallustio and Stefano Vallone and Andrea Zini and Sandra Bracco and Rossana Tassi and Mauro Bergui and Paolo Cerrato and Antonio Pitrone and Francesco Grillo and Andrea Saletti and {De Vito}, Alessandro and Roberto Gasparotti and Mauro Magoni and Edoardo Puglielli and Alfonsina Casalena and Francesco Causin and Claudio Baracchini and Lucio Castellan and Laura Malfatto and Roberto Menozzi and Umberto Scoditti and Chiara Comelli and Enrica Duc and Alessio Comai and Enrica Franchini and Mirco Cosottini and Michelangelo Mancuso and Simone Peschillo and {De Michele}, Manuela and Andrea Giorgianni and Delodovici, {Maria Luisa} and Elvis Lafe and Denaro, {Maria Federica} and Nicola Burdi and Saverio Intern{\`o} and Nicola Cavasin and Adriana Critelli and Luigi Chiumarulo and Marco Petruzzellis and Marco Doddi and Antonio Carolei and William Auteri and Ciceri, {Elisa Francesca Maria}",
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T1 - IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

AU - Listing of IER Collaborators

AU - Cappellari, Manuel

AU - Mangiafico, Salvatore

AU - Saia, Valentina

AU - Pracucci, Giovanni

AU - Nappini, Sergio

AU - Nencini, Patrizia

AU - Konda, Daniel

AU - Sallustio, Fabrizio

AU - Vallone, Stefano

AU - Zini, Andrea

AU - Bracco, Sandra

AU - Tassi, Rossana

AU - Bergui, Mauro

AU - Cerrato, Paolo

AU - Pitrone, Antonio

AU - Grillo, Francesco

AU - Saletti, Andrea

AU - De Vito, Alessandro

AU - Gasparotti, Roberto

AU - Magoni, Mauro

AU - Puglielli, Edoardo

AU - Casalena, Alfonsina

AU - Causin, Francesco

AU - Baracchini, Claudio

AU - Castellan, Lucio

AU - Malfatto, Laura

AU - Menozzi, Roberto

AU - Scoditti, Umberto

AU - Comelli, Chiara

AU - Duc, Enrica

AU - Comai, Alessio

AU - Franchini, Enrica

AU - Cosottini, Mirco

AU - Mancuso, Michelangelo

AU - Peschillo, Simone

AU - De Michele, Manuela

AU - Giorgianni, Andrea

AU - Delodovici, Maria Luisa

AU - Lafe, Elvis

AU - Denaro, Maria Federica

AU - Burdi, Nicola

AU - Internò, Saverio

AU - Cavasin, Nicola

AU - Critelli, Adriana

AU - Chiumarulo, Luigi

AU - Petruzzellis, Marco

AU - Doddi, Marco

AU - Carolei, Antonio

AU - Auteri, William

AU - Ciceri, Elisa Francesca Maria

PY - 2019/4

Y1 - 2019/4

N2 - Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

AB - Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

U2 - 10.1161/STROKEAHA.118.023316

DO - 10.1161/STROKEAHA.118.023316

M3 - Article

C2 - 31233386

VL - 50

SP - 909

EP - 916

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 4

ER -