Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Frequency and risk factors of spontaneous hemorrhagic transformation following ischemic stroke on the initial brain CT or MRI: data from the China National Stroke Registry (CNSR)

First author:Guojuan Chen,Anxin Wang

Corresponding author:Yibin Cao,Yilong Wang

Cerebral infarction Spontaneous hemorrhagic transf

essential_information

2016-06-20

Published articles

Journal:Neurological Research

Publication type: Original Contributions

IF(IF): 2.448

PMID: 27320249 Link To Pubmed Full text Download

Background And Purpose

There are few studies of spontaneous hemorrhagic transformation (HT) after ischemic stroke (IS), and those that are available do not preclude the use of antithrombotic therapy after admission. We aimed to investigate the frequency and risk factors of spontaneous HT in patients who received no therapy between IS onset and the first instance of neurological imaging.

Method

We studied spontaneous HT using the China National Stroke Registry. Spontaneous HT was diagnosed on an initial computed tomography or magnetic resonance imaging scan within 14 days of IS onset. The risk factors associated with spontaneous HT were assessed using univariate analyses and multivariate logistic regression.

Conclusion

Spontaneous HT occurred in 0.92% of the patients with IS in the acute stage. Being female, excess alcohol consumption, atrial fibrillation, and a prolonged period between IS onset and initial imaging were associated with an increased risk of spontaneous HT.

Main results

A total of 12,415 patients were diagnosed with IS, and among them, 114 (0.92%) had spontaneous HT. Multivariate analysis revealed that being female odds ratio (OR, 2.29; 95% CI, 1.52–3.44, p < 0.0001), excess alcohol consumption (OR, 2.17; 95% CI, 1.20–3.94, p = 0.0109), atrial fibrillation (OR, 2.15; 95% CI, 1.26–3.66, p = 0.0051), and a prolonged period between IS onset and initial imaging (1–7 days: OR, 1.64, 95%CI, 1.11–2.42, p = 0.0131; 7–14 days: OR, 3.12, 95% CI, 1.53–6.40, p = 0.0018) were positively associated with spontaneous HT.