Predicting Symptomatic Intracranial Hemorrhage After Mechanical Thrombectomy: The TAG Score (940)

Objective: We aim to determine predictors of symptomatic intracranial hemorrhage (sICH) those predictors with external validation. Background: While predictors of sICH are well established, there is limited data in patients who underwent mechanical thrombectomy. Design/Methods: We evaluated mechanical thrombectomy in a derivation cohort of patients at a comprehensive stroke center over a 30-month period. Clinical and radiographic data on these patients were obtained from the prospective quality improvement database. sICH was defined using the European Cooperative Acute Stroke Study III. We compared clinical and radiographic characteristics between patients with and without sICH using chi-square and t-tests to identify independent predictors of sICH with p Results: We identified 578 patients with acute ischemic stroke who received thrombectomy, 19 had sICH (3.3%). Predictive factors of sICH were: Thrombolysis in cerebral ischemia score (TICI; OR: 5.00 per unit decrease; 95% CI: 1.85–14.29; p = 0.002), Alberta stroke program early computed tomography score (ASPECTS; OR 1.52 per 1 point decrease; 95% CI: 1.15–2.00;.p = 0.003), and Glucose level (OR per 10 mg/dL increase 1.07 per mg/dL increase; 95% CI: 1.01–1.13; p = 0.018), and using the OR of the predictors in the multivariable model, we derived the weighted TAG score which was associated with sICH in the derivation (OR per unit increase 1.98, 95% CI 1.48–2.66, p Conclusions: High TAG scores are associated with sICH in patients receiving mechanical thrombectomy. Larger studies are needed to validate this scoring system and test interventions and strategies to reduce sICH risk and make thrombectomy safer in patients with elevated TAG scores. Disclosure: Dr. Montalvo Perero has nothing to disclose. Dr. Mistry has nothing to disclose. Dr. Chang has nothing to disclose. Dr. Yakhkind has nothing to disclose. Dr. Dakay has nothing to disclose. Dr. Azher has nothing to disclose. Dr. Mistry has nothing to disclose. Dr. Chitale has nothing to disclose. Dr. Cutting has nothing to disclose. Dr. Burton has nothing to disclose. Dr. Mac Grory has nothing to disclose. Dr. Reznik has nothing to disclose. Dr. Mahta has nothing to disclose. Dr. Thompson has nothing to disclose. Dr. Ishida has nothing to disclose. Dr. Frontera has nothing to disclose. Dr. Riina has nothing to disclose. Dr. Gordon has nothing to disclose. Dr. Turkel-Parrella has nothing to disclose. Dr. Scher has nothing to disclose. Dr. Farkas has nothing to disclose. Dr. McTaggart has nothing to disclose. Dr. Khatri has nothing to disclose. Dr. Furie has nothing to disclose. Dr. Jayaraman has nothing to disclose. Dr. Yaghi has nothing to disclose.