Risk factors for hemorrhagic transformation and its subtypes after ischemic stroke

doi:10.3969/j.issn.1009-0126.2017.05.014

Abstract：Objective To study the relationship between Chinese Ischemic Stroke Subclassification (CISS) and hemorragic transformation (HT) after ischemic stroke.Methods One hundred and fifty-five HT patients served as a HT group and 250 HT-free ischemic stroke patients served as a HT-free group in this study.The risk factors for HT subtypes were divided into hemorrhagic infarction stroke (HI) and parenchymal hematoma (PH).HI was divided into HI-1 and HI-2,PH was divided into PH-1 and PH-2.Parameters of demography,medical history,clinical examination,laboratory testing,and imaging were collected from the two groups.The risk factors for HT and its subtypes were analyzed.Results The HI-1 and HI-2,PH-1 and PH-2 accounted for 43.9％ and 33.5％,12.3％ and 10.3％ respectively in HT group.The incidence of large artery atheroclerosis and cardioembolism was rather high in HT group according to the CISS.The incidence of massive isehemic stroke and involvement of cerebral cortex,cardioembolism and HT due to other etiologies according to the CISS and the NIHSS score orn admission were significantly higher while the incidence of penetrating artery disease according to the CISS was significantly lower in HT group than in HT-free group (P＜0.05).The massive ischemic stroke,involvement of cerebral cortex,age and NIHSS score on admission were the independent risk factors for HT while LDL-C and penetrating artery disease were the risk factors for HT.Conclusion Massive ischemic stroke,involvement of cerebral cortex,age and NIHSS score on admission are the independent risk factors for HT.The independent risk factors for HT subtypes are different.