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Is asymptomatic hemorrhagic transformation really innocuous?
1Department of Neurology, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
Neurology
|January 28, 2012
Summary
Asymptomatic hemorrhagic transformation (HT) in acute ischemic stroke patients doubles the odds of a worse 3-month outcome. This finding highlights the importance of monitoring even asymptomatic HT for long-term patient prognosis.
Area of Science:
- Neurology
- Radiology
- Clinical Medicine
Background:
- Asymptomatic hemorrhagic transformation (HT) following acute ischemic stroke is common.
- The long-term clinical significance of asymptomatic HT remains incompletely understood.
- Previous studies suggest no immediate deterioration, but long-term impact is unclear.
Purpose of the Study:
- To investigate the impact of asymptomatic HT on 3-month functional outcomes in acute ischemic stroke patients.
- To determine if asymptomatic HT is clinically innocuous regarding long-term prognosis.
- To quantify the association between asymptomatic HT and modified Rankin Scale (mRS) scores at 3 months.
Main Methods:
- Analysis of a prospective stroke registry database of 1,618 patients hospitalized for ischemic stroke within 7 days of onset.
- Inclusion criteria focused on patients with available 3-month mRS scores and exclusion of symptomatic HT or lack of specific MRI.
- Calculation of odds ratios (OR) for asymptomatic HT associated with functional outcome, adjusted for relevant covariates.
Main Results:
- Out of 1,412 eligible patients, 7.1% (100 patients) experienced asymptomatic HT.
- Patients with asymptomatic HT were more likely to have cardioembolic stroke, receive thrombolytic therapy, heparin anticoagulation, and higher initial NIH Stroke Scale scores.
- Crude and adjusted ORs for asymptomatic HT predicting a worse mRS score at 3 months were 2.94 and 1.90, respectively.
Conclusions:
- Asymptomatic HT significantly increases the odds of a worse 3-month outcome in acute ischemic stroke patients.
- The adjusted odds of a worse outcome are nearly doubled in patients with asymptomatic HT.
- These findings suggest asymptomatic HT is not clinically innocuous and warrants careful consideration in stroke management.
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