Evidence map›Paper›PMID 25572947›Full record

ArticleAJNR. American journal of neuroradiology2015

Contribution and additional impact of imaging to the SPAN-100 score.

P Krishnan, G Saposnik, B Ovbiagele, L Zhang, S Symons, R Aviv

Abstract read
In one paragraph

Article in AJNR. American journal of neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

P KrishnanFrom the Division of Neuroradiology (P.K., S.S., R.A.), Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
G SaposnikStroke Outcome Reach Center (G.S.), Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada.
B OvbiageleDepartment of Neurosciences (B.O.), Medical University of South Carolina, Charleston, South Carolina.
L ZhangBiostatistician (L.Z.), Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
S SymonsFrom the Division of Neuroradiology (P.K., S.S., R.A.), Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
R AvivFrom the Division of Neuroradiology (P.K., S.S., R.A.), Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada richard.aviv@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeStroke Prognostication by Using Age and NIHSS score (SPAN-100 index) facilitates stroke outcomes. We assessed imaging markers associated with the SPAN-100 index and their additional impact on outcome determination. MATERIALS AND

methodsOf 273 consecutive patients with acute ischemic stroke (<4.5 hours), 55 were characterized as SPAN-100-positive (age +NIHSS score ≥ 100). A comprehensive imaging review evaluated differences, using the presence of the hyperattenuated vessel sign, ASPECTS, clot burden score, collateral score, CBV, CBF, and MTT. The primary outcome assessed was favorable outcome (mRS ≤ 2). Secondary outcomes included recanalization, lack of neurologic improvement, and hemorrhagic transformation. Uni- and multivariate analyses assessed factors associated with favorable outcome. Area under the curve evaluated predictors of favorable clinical outcome.

resultsCompared with the SPAN-100-negative group, the SPAN-100-positive group (55/273; 20%) demonstrated larger CBVs (<0.001), poorer collaterals (P < .001), and increased hemorrhagic transformation rates (56.0% versus 36%, P = .02) despite earlier time to rtPA (P = .03). Favorable outcome was less common among patients with SPAN-100-positive compared with SPAN-100-negative (10.9% versus 42.2%; P < .001). Multivariate regression revealed poorer outcome for SPAN-100-positive (OR = 0.17; 95% CI, 0.06-0.38; P = .001), clot burden score (OR = 1.14; 95% CI, 1.05-1.25; P < .001), and CBV (OR = 0.58; 95% CI, 0.46-0.72; P = .001). The addition of the clot burden score and CBV improved the predictive value of SPAN-100 alone for favorable outcome from 60% to 68% and 74%, respectively.

conclusionsSPAN-100-positivity predicts a lower likelihood of favorable outcome and increased hemorrhagic transformation. CBV and clot burden score contribute to poorer outcomes among high-risk patients and improve stroke-outcome prediction.

Indexed as

AgedAged, 80 and overBrain InfarctionCerebral AngiographyFemaleHumansImage Processing, Computer-AssistedIntracranial ThrombosisMaleMiddle AgedMultivariate AnalysisPrognosisRetrospective StudiesSeverity of Illness IndexStrokeTreatment Outcome

Identifiers

PMID25572947
PMCPMC7964323

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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.