NDLI: External validation of the SEDAN score for prediction of intracerebral hemorrhage in stroke thrombolysis.

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External validation of the SEDAN score for prediction of intracerebral hemorrhage in stroke thrombolysis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ahmed, Niaz Mazya, Michael V. Jatuzis, Dalius Kobayashi, Adam Bovi, Paolo Wahlgren, Nils Castillo, José
Description	Country affiliation: Sweden Author Affiliation: Mazya MV ( Department of Neurology, SITS International Coordination Office, Karolinska Stroke Research, Karolinska University Hospital, Solna, Stockholm 17176, Sweden. michael.mazya@karolinska.se)
Abstract	BACKGROUND AND PURPOSE: The SEDAN score is a prediction rule for assessment of the risk of symptomatic intracerebral hemorrhage (SICH) per the European Cooperative Acute Stroke Study (ECASS) II definition in patients with acute ischemic stroke treated with intravenous thrombolysis. We assessed the performance of the score in predicting SICH per the ECASS II and Safe Implementation of Treatments in Stroke Monitoring Study (SITS-MOST) definitions in the SITS-International Stroke Thrombolysis Register (SITS-ISTR). METHODS: We calculated the SEDAN score in 34 251 patients with complete data, enrolled into the SITS-ISTR. The risk for SICH by both definitions was calculated per score category. Odds ratios for SICH per point increase of the score were obtained using logistic regression. The predictive performance was assessed using area under the curve of the receiver operating characteristic (AUC-ROC). RESULTS: The predictive capability for SICH per ECASS II was moderate at AUC-ROC=0.66. With rising scores, there was a moderate increase in risk for SICH per ECASS II (odds ratio, 1.65 per point; 95% confidence interval, 1.59-1.72; P<0.001), with SICH rates between 1.6% for 0 points and 16.9% for ≥ 5 points, average 5.1%. The predictive capability for SICH per SITS-MOST was weaker, AUC-ROC=0.60, with lower increase per score point (odds ratio, 1.36 per point; 95% confidence interval, 1.28-1.46; P<0.001), and SICH rates between 0.8% for 0 points and 5.4% for ≥ 5 points, average 1.8%. CONCLUSIONS: In this very large data set, the predictive and discriminatory performances of the SEDAN score were only moderate for SICH per ECASS II and low for SICH per SITS-Monitoring Study.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	6
Volume Number	44
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2013-06-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Cerebral Hemorrhage Epidemiology Risk Assessment Stroke Drug Therapy Thrombolytic Therapy Fibrinolytic Agents Administration & Dosage Therapeutic Use Injections, Intravenous Logistic Models Retrospective Studies Risk Factors Tissue Plasminogen Activator Research Support, Non-u.s. Gov't Validation Studies Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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