Evidence map›Paper›PMID 19901973›Full record

SynthesisPLoS medicine2009

Inflammatory markers and poor outcome after stroke: a prospective cohort study and systematic review of interleukin-6.

William Whiteley, Caroline Jackson, Steff Lewis, Gordon Lowe, Ann Rumley, Peter Sandercock, Joanna Wardlaw, Martin Dennis, Cathie Sudlow

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PLoS medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 8 pooled it
9.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 8 syntheses or guidelines pooled it, 279 citations in OpenAlex.

  1. Pooled it
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  3. The Role of Biomarkers in Atherothrombotic Stroke-A Systematic Review.International journal of molecular sciences · 2021
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  18. Alterations in the inflammatory homeostasis of aging-related cardiac dysfunction and Alzheimer's diseases.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025
    Review
  19. Article
  20. Review

62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

William WhiteleyDivision of Clinical Neurosciences, Western General Hospital, University of Edinburgh, Edinburgh, United Kingdom. william.whiteley@ed.ac.uk
Caroline Jackson
Steff Lewis
Gordon Lowe
Ann Rumley
Peter Sandercock
Joanna Wardlaw
Martin Dennis
Cathie Sudlow
University of Edinburgh · GBWestern General Hospital · GBUniversity of Glasgow · GBMRC Institute of Genetics and Molecular Medicine · GB

Funding

Chief Scientist Office CAF/06/30Medical Research Council G0800803Wellcome TrustWellcome Trust 063668/Z/01/A
6 · The paper itself

Abstract

backgroundThe objective of this study was to determine whether: (a) markers of acute inflammation (white cell count, glucose, interleukin-6, C-reactive protein, and fibrinogen) are associated with poor outcome after stroke and (b) the addition of markers to previously validated prognostic models improves prediction of poor outcome. METHODS AND

findingsWe prospectively recruited patients between 2002 and 2005. Clinicians assessed patients and drew blood for inflammatory markers. Patients were followed up by postal questionnaire for poor outcome (a score of>2 on the modified Rankin Scale) and death through the General Register Office (Scotland) at 6 mo. We performed a systematic review of the literature and meta-analysis of the association between interleukin-6 and poor outcome after stroke to place our study in the context of previous research. We recruited 844 patients; mortality data were available in 844 (100%) and functional outcome in 750 (89%). After appropriate adjustment, the odds ratios for the association of markers and poor outcome (comparing the upper and the lower third) were interleukin-6, 3.1 (95% CI: 1.9-5.0); C-reactive protein, 1.9 (95% CI: 1.2-3.1); fibrinogen, 1.5 (95% CI: 1.0-2.36); white cell count, 2.1 (95% CI: 1.3-3.4); and glucose 1.3 (95% CI: 0.8-2.1). The results for interleukin-6 were similar to other studies. However, the addition of inflammatory marker levels to validated prognostic models did not materially improve model discrimination, calibration, or reclassification for prediction of poor outcome after stroke.

conclusionsRaised levels of markers of the acute inflammatory response after stroke are associated with poor outcomes. However, the addition of these markers to a previously validated stroke prognostic model did not improve the prediction of poor outcome. Whether inflammatory markers are useful in prediction of recurrent stroke or other vascular events is a separate question, which requires further study. Please see later in the article for the Editors' Summary.

Indexed as

AgedAged, 80 and overBiomarkersBlood GlucoseC-Reactive ProteinFemaleFibrinogenHumansInflammationInterleukin-6Leukocyte CountMaleMiddle AgedOdds RatioPrognosisProspective StudiesBiomarkersBlood GlucoseC-Reactive ProteinFibrinogenInterleukin-6

Identifiers

PMID19901973
PMCPMC2730573
OpenAlexW2048350854

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.