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Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score.

Publication ,  Journal Article
Montalvo, M; Mistry, E; Chang, AD; Yakhkind, A; Dakay, K; Azher, I; Kaushal, A; Mistry, A; Chitale, R; Cutting, S; Burton, T; Mac Grory, B ...
Published in: J Neurol Neurosurg Psychiatry
December 2019

BACKGROUND: There is limited data on predictors of symptomatic intracranial haemorrhage (sICH) in patients who underwent mechanical thrombectomy. In this study, we aim to determine those predictors with external validation. METHODS: We evaluated mechanical thrombectomy in a derivation cohort of patients at a comprehensive stroke centre over a 30-month period. Clinical and radiographic data on these patients were obtained from the prospective quality improvement database. sICH was defined using the European Cooperative Acute Stroke Study III. We compared clinical and radiographic characteristics between patients with and without sICH using χ2 and t tests to identify independent predictors of sICH with p<0.1. Significant variables were then combined in a multivariate logistic regression model to derive an sICH prediction score. This score was then validated using data from the Blood Pressure After Endovascular Treatment multicentre prospective registry. RESULTS: We identified 578 patients with acute ischaemic stroke who received thrombectomy, 19 had sICH (3.3%). Predictive factors of sICH were: thrombolysis in cerebral ischaemia (TICI) score, Alberta stroke program early CT score (ASPECTS), and glucose level, and from these predictors, we derived the weighted TICI-ASPECTS-glucose (TAG) score, which was associated with sICH in the derivation (OR per unit increase 1.98, 95% CI 1.48 to 2.66, p<0.001, area under curve ((AUC)=0.79) and validation (OR per unit increase 1.48, 95% CI 1.22 to 1.79, p<0.001, AUC=0.69) cohorts. CONCLUSION: High TAG scores are associated with sICH in patients receiving mechanical thrombectomy. Larger studies are needed to validate this scoring system and test strategies to reduce sICH risk and make thrombectomy safer in patients with elevated TAG scores.

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Published In

J Neurol Neurosurg Psychiatry

DOI

EISSN

1468-330X

Publication Date

December 2019

Volume

90

Issue

12

Start / End Page

1370 / 1374

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Stroke
  • Risk Assessment
  • Prospective Studies
  • Predictive Value of Tests
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
 

Citation

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Chicago
ICMJE
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Montalvo, M., Mistry, E., Chang, A. D., Yakhkind, A., Dakay, K., Azher, I., … Yaghi, S. (2019). Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score. J Neurol Neurosurg Psychiatry, 90(12), 1370–1374. https://doi.org/10.1136/jnnp-2019-321184
Montalvo, Mayra, Eva Mistry, Andrew Davey Chang, Aleksandra Yakhkind, Katarina Dakay, Idrees Azher, Ashutosh Kaushal, et al. “Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score.J Neurol Neurosurg Psychiatry 90, no. 12 (December 2019): 1370–74. https://doi.org/10.1136/jnnp-2019-321184.
Montalvo M, Mistry E, Chang AD, Yakhkind A, Dakay K, Azher I, et al. Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score. J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1370–4.
Montalvo, Mayra, et al. “Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score.J Neurol Neurosurg Psychiatry, vol. 90, no. 12, Dec. 2019, pp. 1370–74. Pubmed, doi:10.1136/jnnp-2019-321184.
Montalvo M, Mistry E, Chang AD, Yakhkind A, Dakay K, Azher I, Kaushal A, Mistry A, Chitale R, Cutting S, Burton T, Mac Grory B, Reznik M, Mahta A, Thompson BB, Ishida K, Frontera J, Riina HA, Gordon D, Parella D, Scher E, Farkas J, McTaggart R, Khatri P, Furie KL, Jayaraman M, Yaghi S. Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score. J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1370–1374.

Published In

J Neurol Neurosurg Psychiatry

DOI

EISSN

1468-330X

Publication Date

December 2019

Volume

90

Issue

12

Start / End Page

1370 / 1374

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Stroke
  • Risk Assessment
  • Prospective Studies
  • Predictive Value of Tests
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Middle Aged
  • Male