medical decision support medical decision support
Sign In

Hemorrhage After Thrombolysis (HAT) Score of Lou et al for Predicting the Risk of Intracerebral Hemorrhage (ICH) in a Patient with Ischemic Stroke

Description

Lou et al reported the Hemorrhage After Thrombolysis (HAT) score for predicting the risk of intracerebral hemorrhage (ICH) following intravenous tissue plasminogen activator (t-PA) in a patient with ischemic stroke. The authors are from Beth Israel Deaconess Medical Center in Boston.


 

Patient selection: ischemic stroke in the distribution of the middle cerebral artery (MCA) after intravenous t-PA therapy

 

Outcome: intracerebral hemorrhage. It was symptomatic if the NIHSS increased >= 4 points after the baseline assessment. Fatal outcome was associated with in-hospital mortality.

 

Parameters:

(1) history of diabetes OR blood glucose on admission

(2) pretreatment NIHSS score

(3) initial head CT scan

 

Parameter

Finding

Points

history of diabetes

no

0

 

yes

1

blood glucose on admission

<= 200 mg/dL

0

 

> 200 mg/dL

1

pretreatment NIHSS

< 15

0

 

15 to 19

1

 

>= 20

2

initial head CT scan

no easily visible hypodensities

0

 

early visible hypodensity involving less than one third of MCA territory

1

 

easily visible hypodensity involving a third or more of MCA territory

2

 

where:

• In Table 1 an NIHSS score of 20 can be scored as 1 or 2 points. Here is was set to 2 points.

 

HAT score =

= MAX(value for diabetes history, admission glucose) + (points for pretreatment NIHSS) + (points for head CT scan)

 

Interpretation:

• minimum score: 0

• maximum score: 5

 

Score

Symptomatic ICH

0

2%

1

5%

2

10%

3

15%

4 or 5

44%

 

Performance:

• The area under the ROC curve for predicting all hemorrhage was 0.72.

• The area under the ROC curve for predicting symptomatic hemorrhage was 0.74.

 


To read more or access our algorithms and calculators, please log in or register.

Specialty