A Simple Grading Scale for Predicting Symptomatic Intracranial Hemorrhage after Mechanical Thrombectomy

Area of Science:

• Neurology
• Radiology
• Critical Care Medicine

Background:

• Symptomatic intracranial hemorrhage (sICH) is a frequent complication following mechanical embolectomy for acute ischemic stroke.
• Predicting sICH is crucial for patient management and improving outcomes after stroke interventions.

Purpose of the Study:

• To develop and validate a novel grading scale, the STBA score, for predicting sICH after mechanical embolectomy.
• To identify key clinical and radiological predictors of sICH in this patient population.

Main Methods:

• Retrospective collection of demographic and clinical data from patients undergoing mechanical embolectomy.
• Development of the STBA score based on factors including blood pressure, time to groin puncture, blood glucose, and early CT findings (ASPECTS).
• Validation of the STBA score using an independent patient cohort.

Main Results:

• The study analyzed 268 patients, with 11.2% experiencing sICH.
• The STBA score, ranging from 0 to 6, demonstrated good predictive performance with an area under the ROC curve of 0.858 in the derivation set and 0.814 in the validation set.
• Key predictors included elevated systolic blood pressure, longer time to groin puncture, hyperglycemia, and lower ASPECTS scores.

Conclusions:

• The STBA score is a reliable and validated tool for predicting sICH in patients with acute ischemic stroke treated with mechanical embolectomy.
• This scoring system can aid clinicians in risk stratification and personalized treatment strategies.