Stroke (09/20) Vol. 51, No. 9 doi: 10.1161/STROKEAHA.120.030173
Zhang, Xiaohao; Xie, Yi; Wang, Huaiming; et al.
Researchers sought to create a risk model able to predict symptomatic intracranial hemorrhage (sICH) in Chinese ischemic stroke patients who were treated with endovascular thrombectomy (EVT). The team, noting the varying causes of artery occlusion among different ethnic groups, developed the Alberta Stroke Program Early CT Score, Baseline Glucose, Poor Collateral Circulation, Passes With Retriever, and Onset-to-Groin Puncture Time (ASIAN) score. The team’s research included a derivation cohort with 629 patients who underwent EVT from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry in China and a validation cohort with 503 patients from two stroke centers. In the derivation cohort, 87 patients (13.8%) developed sICH, which was diagnosed according to the Heidelberg Bleeding Classification within 24 hours of EVT. In the validation cohort, 54 patients (10.7%) developed sICH. Independent factors of sICH were the Alberta Stroke Program Early CT Score (ASPECTS), baseline glucose level, poor collateral circulation, passes with retriever, and onset-to-groin puncture time >270 minutes. These factors were incorporated into the ASIAN score. The scoring system demonstrated good discrimination in both the derivation cohort, with a C index of 0.771, and the validation cohort, with a C index of 0.758. Additionally, a calibration plot demonstrated good predictive accuracy of the ASIAN score in both cohorts. While additional study is needed to validate the efficacy of the ASIAN score in other populations, the researchers concluded the scoring system was an effective predictor of sICH in the study population.