Multivariate Logistic Analysis Of Risk Factors And Establishment Of Risk Model Of Hemorrhagic Transformation After Cerebral Infarction

Objective To explore the risk factors of hemorrhagic transformation after cerebral infarction and establish a incidence of HT prediction score model.Methods The clinical and neuroimaging data were analyzed retrospectively in 227 Non-lacunar infarction from January 2004 to January 2009 in the first affiliated hospital of shanxi medical university.The risk factors were screened out by Logistic regression analysis and the scores were developed according to regression coefficients.Then the receiver operating characteristic curve was constructed and the cutoff was detemined.Results Seven clinical variables,including cerebral infarction volume,blood glucose level, atrial fibrillation, history of valvular heart disease,history of drinking,systolic blood pressure,positive proteinuria were selected through single factors analysis. The logistic regression analysis showed that there were signigicant differences in 4 factors between the 2 groups. According to the orders of OR values they werw:cerebral farction volume (OR=4.926, 95%CI=2.150-11.287, P<0.001); atrial fibrillation (OR=4.633,95%CI=1.987-10.853, P< 0.001); blood glucose level(OR=3.622,95%CI=2.112-6.213, P< 0.001);systolic blood pressure (OR=1.792,95%CI=1.159～2.767, P=0.009)。The predicted percentage of correct was 83.3%.According to regression coefficients,a score ranging from 5 to 32 was developed,the area under the receiver operating characteristic curve was 0.841.At a cutoff point of 18.5, the hemorrhagic transformation wan predicted with the sensitivity of 72.0%,the specificity of 80.8%, the positive predictive value of 46.84% and the negative predictive value of 91.22%.The incidence of HT was higher in the "high risk group"(the score> 18.5)than that in the "low risk group "(the score≤18.5)(P<0.001).Conclusion The massive cerebral farction,atrial fibrillation, blood glucose level, systolic blood pressure are the major risk factors of hemorrhagic transformation. The patients with the score higher than 18.5 are assessed to be af"high risk"for the incidence of hemorrhagic transformation.