IER-SICH Nomogram of Cappellari et al for Prediction of Symptomatic Intracerebral Hemorrhage (SICH) After Thrombectomy for Stroke

Description

Cappellari et al reported a nomogram for predicting symptomatic intracerebral hemorrhage following thrombectomy in a patient with an acute stroke. This can help to identify a patient who may benefit from more aggressive management. The authors are from the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke).

Patient selection: after thrombectomy for acute stroke

Outcome: symptomatic intracerebral hemorrhage (sICH)

Parameters:

(1) Careggi collateral score (integer from 0 to 4)

(2) successful recanalization (Thrombolysis in Cerebral Infarction, TICI 2b/d)

(3) minutes from onset to procedure

(4) age in years

(5) baseline NIHSS score

Parameter	Finding	Points
Careggi collateral score		4.5 - (1.125 * (score))
recanalization	no	1.8
	yes	0
onset	from 100 to 690	(0.01443 * (minutes)) + 0.03329
age	from 18 to 93	(0.07662 * (years)) + 0.04921
NIHSS score	2	0.4
	3	0.65
	4 to 31	(0.1663 * (NIHSS)) + 0.2246

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score:3.3

• maximum score: 28.9

• The higher the score the greater the risk of symptomatic ICH.

X =

= (0.4062 * (total score)) - 8.895

percent probability of sICH =

= 1 / (1+ EXP((-1) * X))

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