Abstract TP138: SITS Symptomatic Intracerebral Hemorrhage Risk Score in the Stroke Belt
Background: sICH remains the most feared complication of IV tPA treatment. SITS investigators developed a clinical score to predict sICH in European stroke patients. We aimed to investigate the how this score would perform in IV tPA treated patients at two centers in the US Stroke Belt.
Methods: We retrospectively reviewed IV tPA treated consecutive patients from two centers in the Stroke Belt (2008-2011). The SITS Symptomatic Intracerebral Hemorrhage Risk Score was calculated using published criteria. sICH was defined as a type 2 parenchymal hemorrhage with deterioration in NIHSS score of 4 points or death. Only patients with all 9 variables needed to calculate the SITS sICH scores were included. Logistic regression was used to investigate the predictive ability of the score.
Results: During the study period, 457 patients were treated with IV tPA (sICH 4.2%). Among the 220 patients with all 9 variables, 19 (8.6%) had sICH. The SITS sICH scores and other variables are shown in the Table. SITS score was not a predictor of sICH in overall patient sample (OR=1.16, 95% CI 0.856-1.57, p=0.3387). The score performed poorly in Blacks (OR 1.18, 95% CI 0.79-1.77, p=0.417) as compared to Whites (OR 1.19, 95% CI 0.77-1.82, p=0.438) for prediction of sICH, Figure. However, SITS score was predictive of mRS 4-6 at discharge (OR=1.34, 95% CI 1.16-1.55, p<0.001).
Conclusions: SITS sICH score was not predictive of sICH in Stroke Belt patients, particularly among Blacks. The specific components of the 9 variable score needs to be re-evaluated individually for point estimates specific for the Stroke Belt population.
- © 2012 by American Heart Association, Inc.