RESUMO
Abstract: At present; the only specific medical treatment for acute ischaemic stroke is intravenous administration of recombinant tissue plasminogen activator within 4.5 hours of stroke onset. In the last year; two scores for risk stratification of intracranial haemorrhage have been derived from multicentric European trial groups; the Safe Implementation of Treatment in Stroke - Symptomatic IntraCerebral Haemorrhage risk score (SITS-SICH) and the SEDAN score. The aim of this study was to pilot their use in a cohort of patients treated at a South African tertiary hospital. Prospectively collected data were used from a cohort of 41 patients who underwent thrombolysis at Groote Schuur Hospital from 2000 to 2012. Computerised tomography brain imaging was available for review in 23 of these cases. The SITS-SICH and SEDAN scores were then applied and risk prediction was compared with outcomes.Two patients suffered symptomatic intracranial haemorrhage (SICH); representing 4.9 (95 CI: 0-11.5) of the cohort. This was comparable to the SICH rate in both the SITS-SICH (5.1) and SEDAN (6.5) cohorts. Patient scores in the Groote Schuur Hospital cohort appeared similar to those of the validation cohorts of both SITS-SICH and SEDAN. With increasing use of thrombolysis in a resource-constrained setting; these scores represent a potentially useful tool in patient selection of those most likely to benefit from intravenous thrombolysis; reducing risk for SICH and with the added benefit of curtailing cost. (95 CI: 0-11.5) of the cohort. This was comparable to the SICH rate in both the SITS-SICH (5.1) and SEDAN (6.5) cohorts. Patient scores in the Groote Schuur Hospital cohort appeared similar to those of the validation cohorts of both SITS-SICH and SEDAN. With increasing use of thrombolysis in a resource-constrained setting; these scores represent a potentially useful tool in patient selection of those most likely to benefit from intravenous thrombolysis; reducing risk for SICH and with the added benefit of curtailing cost