SEDAN Score of Strbian et al for Predicting Symptomatic Intracranial Hemorrhage after Stroke Thrombolysis

Description

Strbian et al reported the SEDAN score for predicting symptomatic intracranial hemorrhage for patients following intravenous thrombolytic therapy for ischemic stroke. The authors are from Helsinki University, University Hospital Basel, Vaud University Hospital, University of Lausanne, and University Hospitals of Geneva.

Patient selection: status post intravenous thrombolytic therapy for ischemic stroke

Outcome: symptomatic intracranial hemorrhage (clinical deterioration causing an increase in the NIHSS score >= 4 points due to intracranial bleeding)

Parameters:

(1) S for sugar (glucose) on admission in mmol/L

(2) E for early infarct signs on admission CT head scan

(3) D for dense or hyperdense cerebral artery sign on admission CT head scan

(4) A for age in years

(5) N for NIHSS score on admission

Parameters	Findings	Points
sugar on admission	<= 8 mmol/L (<= 144 mg/dL)	0
	8.1 to 12 mmol/L	1
	> 12 mmol/L (> 216 mg/dL)	2
early infarct signs	no	0
	yes	1
dense or hyperdense cerebral artery sign	no	0
	yes	1
age in years	<= 75 years of age	0
	> 75 years of age	1
NIHSS on admission	<= 9	0
	>= 10	1

where:

• Early infarct signs include: hypoattenuation comprising less than one third of the middle cerebral artery territory, obscuratio of the lentiform nucleus, loss of basal ganglion outline, loss of insular ribbon, obscuration of the Sylvian fissure, or cortical sulcal effacement.

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score 6

Score	Risk for Symptomatic ICH
0	1.4%
1	2.9%
2	8.5%
3	12.2%
4	21.7%
5	33.3%
6	NA

Performance:

• The area under the ROC curve was 0.77.

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SEDAN Score of Strbian et al for Predicting Symptomatic Intracranial Hemorrhage after Stroke Thrombolysis

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