Abstract TP318: Hemorrhagic Transformation in Acute Ischemic Stroke: A Quantitative Systematic Review

Objective: Hemorrhagic transformation (HT) is common in patients with acute ischemic stroke and is associated with poor outcome. However, the accurate prevalence and risk factors for HT are uncertain. We aim to characterize rates, risk factors and prognosis of HT. Methods: We conducted a systematic review and meta-analysis of all published English literature of patients with acute ischemic stroke and HT. Medline and EMBASE were searched between 1985 and 2017, 2,099 relevant publications were identified. To obtain comparable data we included only studies that used the ECASS-2 definitions of Hemorrhagic Transformation and Parenchymal Hematoma (PH). Patients treated with intravenous thrombolysis (IV-tPA) were compared with those who did not receive thrombolysis. Results: Eligible studies (n=65) with 17,259 patients in total were included in this analysis. The overall prevalence of HT was 27% (95% CI 23-30); Patients not treated with IV-tPA had a prevalence of 20% (95% CI 14-27) vs. 32% (95% CI 27-37) in thos...