THRIVE Score Predicts Ischemic Stroke Outcomes and Thrombolytic Hemorrhage Risk in VISTA

Flint, Alexander C.; Faigeles, Bonnie; Cullen, Sean P.; Kamel, Hooman; Rao, V.; Gupta, Rishi; Smith, Wade S.; Bath, Philip M.W.; Donnan, Geoffrey A.

doi:10.1161/strokeaha.113.002794

Cited by 92 publications

(115 citation statements)

References 15 publications

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“…At least 7 such risk prediction scores have been proposed (Table 3). 9,[24][25][26][27][28][29] Validation studies comparing these scores in different populations of alteplasetreated patients have shown similar predictive values for the various scores (Table 3). [30][31][32][33][34][35][36][37] Although these scores generally are effective at estimating the incremental sICH risk facing individual patients, the upper range of absolute sICH risk predicted by the scores does not justify withholding thrombolytic therapy.…”

Section: Strokementioning

confidence: 92%

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Yaghi¹,

Willey²,

Cucchiara³

et al. 2017

Stroke

382

307

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Purpose— Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment. Methods— A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. The document sections were divided among writing group members who performed the literature review, summarized the literature, and provided suggestions on the diagnosis and treatment of patients with sICH caused by systemic thrombolysis with alteplase. Several drafts were circulated among writing group members until a consensus was achieved. Results— sICH is an uncommon but severe complication of systemic thrombolysis in acute ischemic stroke. Prompt diagnosis and early correction of the coagulopathy after alteplase have remained the mainstay of treatment. Further research is required to establish treatments aimed at maintaining integrity of the blood-brain barrier in acute ischemic stroke based on inhibition of the underlying biochemical processes.

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Section: Strokementioning

confidence: 92%

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Yaghi¹,

Willey²,

Cucchiara³

et al. 2017

Stroke

382

307

View full text Add to dashboard Cite

show abstract

“…1 Various pretreatment clinical and imaging factors have been associated with hemorrhagic transformation after reperfusion treatment, including age, severity of pretreatment neurologic deficit, ischemic lesion volume, elevated blood pressure, serum glucose level, history of diabetes, and absence of collateral flow. [2][3][4][5] However, most available data on ICH following recanalization therapy in acute ischemic stroke are from studies of intravenous and intra-arterial pharmacologic fibrinolysis and little is known about the clinical and procedural factors contributing to ICH occurrence after mechanical neurothrombectomy. 6,7 The clinical impact of different ICH subtypes has also been incompletely studied.…”

mentioning

confidence: 99%

Determinants of Intracranial Hemorrhage Occurrence and Outcome after Neurothrombectomy Therapy: Insights from the Solitaire FR With Intention For Thrombectomy Randomized Trial

Raychev

Jahan

Liebeskind

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Intracranial hemorrhage is the most dreaded complication of neurothrombectomy therapy for acute ischemic stroke. The determinants of intracranial hemorrhage and its impact on clinical course remain incompletely delineated. The purpose of this study is to further investigate the clinical and procedural factors leading to intracranial hemorrhage and to define the clinical impact of different hemorrhagic subtypes.

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“…THRIVE and NIHSS were fairly accurate to predict worse functional outcome at hospital discharge. In previous studies THRIVE was shown to be a good predictor of clinical outcome, hemorrhagic transformation, and outcome after endovascular 10 and intravenous stroke treatment 11,12 . This score has been previously tested in North American, European, and Asian populations; however, to the best of our knowledge, this was the first study to evaluate this score in a South American population.…”

Section: Discussionmentioning

confidence: 92%

Performance of four ischemic stroke prognostic scores in a Brazilian population

Kuster

Dutra

Brasil

et al. 2016

Arq. Neuro-Psiquiatr.

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Objective Ischemic stroke (IS) prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS), Stroke Prognostication Using Age and NIHSS (SPAN-100), Acute Stroke Registry and Analysis of Lausanne (ASTRAL), and Totaled Health Risks in Vascular Events (THRIVE) were compared. Results Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.

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THRIVE Score Predicts Ischemic Stroke Outcomes and Thrombolytic Hemorrhage Risk in VISTA

Cited by 92 publications

References 15 publications

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Determinants of Intracranial Hemorrhage Occurrence and Outcome after Neurothrombectomy Therapy: Insights from the Solitaire FR With Intention For Thrombectomy Randomized Trial

Performance of four ischemic stroke prognostic scores in a Brazilian population

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