SynthesisJournal of neurology2014
Cortisol levels and the severity and outcomes of acute stroke: a systematic review.
Synthesis in Journal of neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as prognostic predictors for delirium in critically ill patients: a systematic review and meta-analysis.BMC anesthesiology · 2023Pooled it
- Brain-Heart Axis and Biomarkers of Cardiac Damage and Dysfunction after Stroke: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2020Pooled it
- Fluoxetine to improve functional outcomes in patients after acute stroke: the FOCUS RCT.Health technology assessment (Winchester, England) · 2020Trial
- Trial
- Gut dysbiosis impairs HPA axis function and exacerbates post-stroke inflammation in high-fat diet-fed male mice.Microbiology spectrum · 2026Article
- Dysregulated neuroendocrine stress response and blood pressure management burden are linked to remote diffusion-weighted imaging lesions after intracerebral hemorrhage: a prospective pilot study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Potential of Saliva in Stroke Patients: A Review.International journal of molecular sciences · 2026Review
- Article
- Lack of cortistatin drives neuroimmune and vascular dysfunction in brain ischemia.Journal of biomedical science · 2026Article
- Role of Exercise in Modulating the Brain-Heart Axis in Cardiovascular Diseases.International journal of molecular sciences · 2026Review
- Central neuroendocrine dysregulation in ischaemic stroke sequelae: pathophysiological mechanisms-a narrative review.Frontiers in human neuroscience · 2026Review
- Prevalence, Predictors, and Prognosis of Depression After Transient Ischemic Attack: A Population-Based Study.Stroke · 2026Article
- Beyond the usual suspects: rethinking post-stroke immunosuppression.Frontiers in immunology · 2026Review
- Association between blood urea nitrogen levels and mortality in critical acute ischemic stroke patients.Scientific reports · 2025Article
- A novel approach to the prevention and management of cardiovascular diseases: targeting brain-heart axis.European journal of medical research · 2025Review
- Article
- Acute Myocardial Infarction: Molecular Pathogenesis, Diagnosis, and Clinical Management.MedComm · 2025Review
- Article
- A Systematic Scoping Review of Measures Used to Evaluate Treatment-Induced Changes in Depression, Anxiety, and Chronic Stress in People with Post-Stroke Aphasia.Aphasiology · 2025Article
- Neutrophil-related immune-inflammatory biomarkers influence the early progression of medial medullary infarction.Frontiers in neurology · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Studies in non-stroke patients have shown an association between dysregulation of the hypothalamic-pituitary-adrenal axis and morbidity and mortality. We conducted a systematic review to evaluate cortisol levels in acute stroke and their associations with outcome. We searched MEDLINE and EMBASE for articles up to April 2013 and PsychINFO for articles up to July 2013, using the keywords "cortisol" and "stroke" and associated terms or synonyms. We included studies published in peer-reviewed journals that recruited 10 or more participants and measured cortisol at least once in the first year following stroke. Data were extracted regarding cortisol levels, including changes over time and their relationship to stroke severity, and outcome. Of 11,240 abstracts, 101 full texts were obtained and 48 fulfilled our inclusion criteria. Cortisol levels were high in the first week after stroke in the majority of studies (26 studies, n = 1,340). Higher cortisol was associated with dependency (8/11 studies, n = 822), delirium (5/6 studies, n = 269) depression (3/5 studies n = 117) and mortality (8/10 studies, n = 856). Five studies adjusted for stroke severity; one found an association between higher cortisol and dependency, and three found an association between higher cortisol and mortality. Cortisol levels are high for at least 7 days after stroke. Elevated cortisol after stroke is associated with dependency, morbidity, and mortality; however, there is insufficient evidence to conclude that these relationships are independent of stroke severity.
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Registered trials
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.