Predictors of Hemorrhagic Transformation in Patients Receiving r-tPA
Abstract Background intravenous recombinant tissue-type plasminogen activator (r-tPA) is a proven intervention for acute ischemic stroke patients. The rationale behind the use of r-tPA in ischemic stroke is breaking down the clot and recanalization of the occluded blood vessels. The restoration of blood vessel patency is meaningful only if the brain tissue of the ischemic area is still viable. Intravenous thrombolysis showed moderate benefit upon administration between three and four and half hours from stroke onset. Aim of the Work assess the risk factors that lead to occurrence of hemorrhagic transformation in patients with acute ischemic stroke received intravenous thrombolytic during their hospital stay. Patients and Methods This is a retrospective cross-sectional observational study conducted in Ain Shams University hospital and Ain Shams University Specialized hospital. 200 patients were included in the study. All were in-patients, admitted in the stroke unit either in Ain Shams University hospital or Ain Shams University Specialized hospital. Patients were diagnosed by neurological history, clinical examination and radiological investigations (CT scan with or without MRI brain stroke protocol). The diagnosis of stroke must be made by a neurologist. Results there was statistically significant association found between hemorrhagic transformation and smoking and also onset of stroke while no statistically significant association found with BP during injection and RBS. Conclusion there was highly statistically significant associaton between hemorrhagic transformation and onset of stroke with p-value = 0.006 and OR (95% CI) 5.92 (1.656–21.165) while there was statistically significant association found with smoking with p-value = 0.012 and OR (95% CI) 2.424 (1.214–4.844).