Prognosis of Hemorrhagic Transformation in Acute Ischemic Stroke Patients Received Revascularization Treatment

Truong SV, Truong ALT and Nguyen TH

Published on: 2025-09-07

Abstract

Background and Objective: Early prediction of hemorrhagic transformation (HT) in acute ischemic stroke patients undergoing revascularization therapy plays a part in treatment planning and providing necessary information for patients and their families. Therefore, our objective is to find factors that can predict HT.

Subjects and Methods: Prospective study including 220 acute ischemic stroke patients receiving revascularization treatment at People's Hospital 115, Ho Chi Minh City. Subjects recruited upon admission were collected medical history, NIHSS score, HAT score, ASPECT score, clinical, paraclinical and brain imaging (CTscan/MRI). Subjects had NIHSS scores and imaging collected within 24 ± 6 hours after revascularization treatment. Univariate analysis and multivariate regression analysis were used to determine the role of variables on HT.

Results: The mean age was 63 years old, 63.6% were male. There were 14 factors univariately associated with HT after 24 ± 6 hours of revascularization treatment in patients with acute ischemic stroke: HAT, NIHSS, ASPECT, age, smoking, hypertension, valvular heart disease, diabetes, heart rate, diastolic blood pressure, conscious disorders, cerebral artery hyperdense sign, blood glucose, and red blood cells. Among them, cerebral artery hyperdense sign and especially HAT were two independent prognostic factors for HT through multivariate analysis. HAT had very strongly related to HT, HAT ≥ 2 were prognostic patients with HT after 24 ± 6 hours of recanalization treatment with a sensitivity of 94.3%; Specificity was 90.8%; The area under the curve was 96.5% and the positive predictive value was 91.1%.

Conclusion: In patients with acute ischemic stroke treated with revascularization, cerebral artery hyperdense sign and HAT score at admission were the 2 strongest and independent prognostic factors of HT after 24 ± 6 hours since the patient received recanalization treatment.