Abstract Details

Title Prevalence and Risk Factors for Hemorrhagic Transformation in Patients with Posterior Circulation Ischemic Stroke: A Systematic Review and Meta-Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-008

Objective

To determine the prevalence of hemorrhagic transformation (HT) and identify associated risk factors in patients with posterior circulation ischemic stroke (PCIS).

Background

PCIS constitutes approximately 20% of all ischemic stroke cases. HT is a recognized complication of ischemic stroke, leading to worsened outcomes. While extensive research has focused on HT in anterior circulation strokes, data on HT prevalence and risk factors in PCIS remains limited.

Design/Methods

A systematic search of three databases was conducted up to August 2024.. Case-control, cohort and cross-sectional studies reporting the prevalence of HT and symptomatic intracranial hemorrhage (sICH) and associated risk factors were selected. A meta-analysis using a random-effects model was planned for pooled effect estimates where applicable, and a narrative synthesis was provided when meta-analysis was not feasible. The risk of bias was assessed using the Joanna Briggs Institute (JBI) tool for prevalence studies, and the certainty of evidence (CoE) was evaluated with GRADE criteria.

Results Twelve studies were included in the final analysis, with a predominance of female patients (55.9%) and a mean age of 66.8 years. All studies demonstrated a low risk of bias. The pooled prevalence of HT was 12.0% (1,359 participants; 95% CI: 8.0%-18.0%; I² = 85%; CoE: very low), while the prevalence of symptomatic HT was 34.0% (7 studies; 147 participants; 95% CI: 17.0%-53.0%; I² = 78%; CoE: very low). A higher National Institutes of Health Stroke Scale (NIHSS) score was identified as an independent risk factor for HT, and an eTICI score of 0-2a was a predictor of sICH.

Conclusions Our analysis shows a significant prevalence of HT in PCIS patients, with higher NIHSS scores consistently linked to increased risk. However, the very low certainty of evidence and limited studies highlight the need for more robust research.

Authors/Disclosures
Karlos A. Acurio, MD (Universidad Peruana Cayetano Heredia) PRESENTER	Mr. Acurio has nothing to disclose.
Fritz F. Vascones Roman, Sr.	Mr. Vascones Roman has nothing to disclose.
Carlos Rodrigo Q. Vicuña	Mr. Vicuña has nothing to disclose.
Luis S. Aguilar Alvarez	Dr. Aguilar Alvarez has nothing to disclose.
Demy Vascones Roman, Sr., Miss	Mrs. Vascones Roman has nothing to disclose.
Gerardo M. Luna-Peralta	Mr. Luna-Peralta has nothing to disclose.
Meiling M. Carbajal Galarza, MD	Miss Carbajal Galarza has nothing to disclose.
Andy S. Vascones Aldazabal III, PA	Dr. Vascones Aldazabal has nothing to disclose.
Jack Vascones Roman	Mr. Vascones Roman has nothing to disclose.
Brigith R. Avila Lucas, Sr., MD	Dr. Avila Lucas has nothing to disclose.
Irving G. Calisaya-Madariaga, Sr. (Universidad Peruana Cayetano Heredia)	Mr. Calisaya-Madariaga has nothing to disclose.
Niels V. Pacheco, MD	Mr. Pacheco has nothing to disclose.

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