Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After…

Cohort studyBrain sciences· Jun 2026

Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke.

Nguyen Van Tuyen, Nguyen Van Tuan, Tran Tien Dung … Le Duy Cuong

NeuroendovascularCohort studyPrognosisQ2IF 3.6

ASPECTS, fibrinogen, and platelet count together predict hemorrhage after thrombectomy

Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke.

Nguyen Van Tuyen … Le Duy Cuong

Brain sciences · Jun 2026

Background

Hemorrhagic transformation (hemorrhagic transformation) is a major complication after mechanical thrombectomy (mechanical thrombectomy) in acute ischemic stroke (acute ischemic stroke).

Purpose

This study evaluated the predictive value of baseline ASPECTS, fibrinogen level, and platelet count for hemorrhagic transformation after mechanical thrombectomy.

Methods

We retrospectively analyzed 274 acute ischemic stroke patients treated with mechanical thrombectomy.

n = 274 patients

Results

AUROC of the combined model, closer to 1.0 means better hemorrhage prediction

OR by subgroup · 95% CI

More results

Hemorrhagic transformation occurred in 52/274 patients (19.0%).

Baseline ASPECTS (adjusted OR 0.73, 95% CI 0.61-0.88; p = 0.001), fibrinogen level (adjusted OR 0.51, 95% CI 0.32-0.79; p = 0.003), and platelet count (adjusted OR 0.99, 95% CI 0.99-1.00; p = 0.018) were independently associated with hemorrhagic transformation.

More results

Baseline ASPECTS showed the highest discriminative ability among individual predictors (AUC = 0.684), whereas baseline NIHSS score showed poor performance (AUC = 0.539).

Similarly, the full model did not significantly outperform baseline ASPECTS ( p = 0.120).

“

Conclusion · 1 of 2

Baseline ASPECTS, fibrinogen level, and platelet count are independent predictors of hemorrhagic transformation after mechanical thrombectomy.

Conclusion · 2 of 2

A reduced model incorporating these variables demonstrated modest-to-acceptable and parsimonious predictive performance, although external validation is required before clinical implementation.

Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke.

Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke.

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