Saturday, June 06, 2009

Number to harm with iv tpa


Saver JL Hemorrhage after thrombolytic therapy for stroke. The clinically relevant number needed to harm Stroke 2007; 38: 2279-2283

Author reviews original NINDS data on hemorrhages, n=20/312 patients treated, and noted that they tended to be older, have mass effect on CT, have higher serum glucose, and more severe strokes. The number needed to harm, ie an additional dead or disabled outcome (MRS>= 3) attributable to SICH is 707, based on the expected outcome of these 20 patients.

NNH for dead disabled outcome MRS (.=4) 126, for fatal outcome 36.5, and for worsening of any degree between 30 and 40.

Basic conclusion is that most patients with SICH are destined for bad outcomes from the get go.

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