Predictors for Hemorrhagic Transformation among Patients with Ischemic Stroke Admitted in a Tertiary Hospital in the Philippines from July 2018-July 2019

Abstract

Background. Among the multiple scoring systems for hemorrhagic transformation, only few of these address
spontaneous hemorrhagic transformation after an ischemic stroke, with most done with Western population data.

Objectives. This study aims to identify the predictors for hemorrhagic transformation among patients with ischemic stroke admitted in a tertiary hospital in Cebu City, Philippines.

Methods. This is a retrospective cohort study of patients with ischemic stroke admitted in a tertiary hospital in
Cebu City. Patients’ baseline characteristics, clinical, and radiologic data were collected. Chi square test and t-test
were used to determine which variables were significantly different between patients with and without hemorrhagic transformation. Odds ratio (OR) and 95% confidence interval (CI) were determined to measure the association between the different variables and hemorrhagic transformation.

Results. A total of 500 ischemic stroke patients were included in the study. There were 28 (6%) ischemic stroke
patients with Hemorrhagic Transformation. The mean age of these patients is 66.93 ± 12.42 years, 48.8% male, 10.8% had atrial fibrillation, and 2.4% had myocardial infarction. Controlling for the effect of confounders, white blood cell count (OR 1.11; 95% CI 1.03-1.19), myocardial infarction (OR 5.25; 95% CI 1.13-24.34), and presence of brain edema (OR 2.86; 95% CI 1.05-7.80) were significant predictors of hemorrhagic transformation.

Conclusion. White blood cell count, presence of brain edema, and myocardial infarction were significantly associated with hemorrhagic transformation among ischemic stroke patients.