{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:14:09Z","timestamp":1783660449199,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Hemorrhagic transformation (HT) is a major complication after mechanical thrombectomy (MT) in acute ischemic stroke (AIS). This study evaluated the predictive value of baseline ASPECTS, fibrinogen level, and platelet count for HT after MT. Methods: We retrospectively analyzed 274 AIS patients treated with MT. HT within 24 h was identified using follow-up imaging. Logistic regression, ROC analysis, DeLong tests, and bootstrap resampling (1000 iterations) were performed to evaluate predictors and model performance. Results: HT occurred in 52\/274 patients (19.0%). Baseline ASPECTS (adjusted OR 0.73, 95% CI 0.61\u20130.88; p = 0.001), fibrinogen level (adjusted OR 0.51, 95% CI 0.32\u20130.79; p = 0.003), and platelet count (adjusted OR 0.99, 95% CI 0.99\u20131.00; p = 0.018) were independently associated with HT. Baseline ASPECTS showed the highest discriminative ability among individual predictors (AUC = 0.684), whereas baseline NIHSS score showed poor performance (AUC = 0.539). The reduced model combining baseline ASPECTS score, fibrinogen level, and platelet count achieved a balanced discriminative performance (AUC = 0.739), with no significant difference compared with the full model (p = 0.804) or baseline ASPECTS alone (p = 0.112). Similarly, the full model did not significantly outperform baseline ASPECTS (p = 0.120). Bootstrap validation confirmed model stability. Conclusions: Baseline ASPECTS, fibrinogen level, and platelet count are independent predictors of HT after MT. A reduced model incorporating these variables demonstrated modest-to-acceptable and parsimonious predictive performance, although external validation is required before clinical implementation.<\/jats:p>","DOI":"10.3390\/brainsci16070704","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:50:37Z","timestamp":1782867037000},"page":"704","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline ASPECTS, Fibrinogen Level, and Platelet Count for Predicting Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2119-4160","authenticated-orcid":false,"given":"Nguyen Van","family":"Tuyen","sequence":"first","affiliation":[{"name":"Department of Stroke, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"},{"name":"VNU University of Medicine and Pharmacy, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Van","family":"Tuan","sequence":"additional","affiliation":[{"name":"Department of Stroke, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Tien","family":"Dung","sequence":"additional","affiliation":[{"name":"Department of Stroke, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Ngoc","family":"Hien","sequence":"additional","affiliation":[{"name":"Department of Stroke, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Chi","family":"Vien","sequence":"additional","affiliation":[{"name":"Department of Stroke, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Cam","family":"Thach","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Medical Laboratory Center, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Hoang","family":"Ngoc","sequence":"additional","affiliation":[{"name":"Department of Neurology, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6967-5601","authenticated-orcid":false,"given":"Le Duy","family":"Cuong","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hai Ba Trung Ward, Hanoi 10000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"l6983","DOI":"10.1136\/bmj.l6983","article-title":"Management of acute ischemic stroke","volume":"368","author":"Phipps","year":"2020","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102758","DOI":"10.1016\/j.eclinm.2024.102758","article-title":"Global, regional, and national burden of ischemic stroke, 1990\u20132021: An analysis of data from the global burden of disease study 2021","volume":"75","author":"Li","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Liu, S., Li, Y., Lan, X., Wang, L., Li, H., Gu, D., Wang, M., and Liu, J. 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