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Increased Risk of Intracranial Hemorrhage and Mortality Following Thrombolysis in Patients with Stroke and Active Cancer

Authors
 Kwon-Duk Seo  ;  Sang Hyun Suh  ;  Ji Hoe Heo  ;  Byung Moon Kim  ;  Kyung-Yul Lee 
Citation
 Journal of Neurosonology and Neuroimaging, Vol.10(2) : 122-132, 2018 
Journal Title
 Journal of Neurosonology and Neuroimaging 
ISSN
 2635-425X 
Issue Date
2018
Keywords
Neoplasms ; Thrombectomy ; Tissue plasminogen activator ; Hemorrhage ; Mortality
Abstract
Background ; The cerebrovascular disease is not uncommon in cancer patients. However, the effectiveness and safety of thrombolysis for acute ischemic stroke in this patient group has not been established well. We aimed to investigate the outcomes of thrombolysis for the patients suffering from cancer. Methods : We conducted a retrospective analysis using database of patients who had received thrombolysis in two university hospitals. Included patients were those who had received intravenous thrombolysis or endovascular therapy. We compared mortality, and the incidence of hemorrhagic transformation (HT) and symptomatic intracerebral hemorrhage (sICH) between patients with active cancer and those without. Results : Among a total of 627 patients, 42 (6.7%) had a medical history of active cancer. The mortality was higher in cancer patients than the others (27.5% vs. 13.7%, p=0.023). The existence of cancer was one of the factors to increases the risk of mortality (adjusted odds ratio, 3.354; 95% confidence interval, 1.416-7.947; p=0.006). From the 240 patients treated with intravenous thrombolysis only, the incidence of HT (53.8% vs. 16.3%, p=0.003), sICH (30.8% vs. 2.2%, p=0.001), and mortality (41.7% vs. 8.1%, p=0.003) was higher in cancer patients than the patients without. Conclusion : Comorbidity with cancer raised the risk of mortality in patients when treated with thrombolysis. The patients with cancer had more bad outcomes with intravenous thrombolysis only. Our data suggest that the decision of thrombolytic treatment for cancer patients requires careful consideration.
DOI
10.31728/jnn.2018.00020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
김병문(Kim, Byung Moon) ORCID logo https://orcid.org/0000-0001-8593-6841
서상현(Suh, Sang Hyun) ORCID logo https://orcid.org/0000-0002-7098-4901
이경열(Lee, Kyung Yul) ORCID logo https://orcid.org/0000-0001-5585-7739
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167112
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