Individualized tool in ENCHANTED

An individualized decision making tool for use of low versus standard dose alteplase in acute ischemic stroke

Population of interest: thrombolysis eligible patients with acute ischemic stroke


      Benefit: scores 0-1 on the modified Rankin Scale at 90-days;

      Risk: symptomatic intracerebral hemorrhage defined by SITS-MOST


  • Age
  • Baseline NIHSS score
  • SBP
  • Pre-stroke mRS
  • Atrial Fibrillation
  • Diabetes mellitus

Risk Score Calculators

Excel spreadsheets

Table 1 Final predictive model for benefit* at 90 days

EstimateSEP value
mRS modified Rankin scale, NIHSS National Institutes of Health Stroke Scale, BP blood pressure
*according to scores 0-1 on the mRS at 90-days
Systolic BP-0.005980.002040.003
NIHSS 5-10-0.96670.1102<.0001
NIHSS 11-15-1.90480.1299<.0001
NIHSS ≥16-2.45690.1431<.0001
Pre-stroke function (mRS 1 vs. 0)-0.79210.1089<.0001
Atrial fibrillation (Yes vs. No)1.39550.64710.031
Diabetes mellitus (Yes vs. No)-0.26040.09960.009
Randomised treatment (low vs. standard-dose alteplase)-0.14430.07880.067
Age * atrial fibrillation-0.02380.009050.009


Table 2 Final predictive model for the risk of symptomatic intracranial hemorrhage*

EstimateSEP value
BP blood pressure
*defined according to the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST)
Systolic BP0.02060.007830.009
Atrial fibrillation (Yes vs. No)1.33160.2873<0.0001
Randomised treatment (low vs. standard-dose alteplase)-0.80180.30540.009