Evidence map›Paper›PMID 25691004›Full record

ArticleNeurocritical care2015

Cohort-Based Identification of Predictors of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis.

David Asuzu, Karin Nyström, Hardik Amin, Joseph Schindler, Charles Wira, David Greer, Nai Fang Chi, Janet Halliday, Kevin N Sheth

Abstract read
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Article in Neurocritical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
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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

9 authors at 3 institutions in 2 countries.

David AsuzuDepartment of Neurology, Yale School of Medicine, 15 York Street, LCI 10, New Haven, CT, 06510, USA. david.asuzu@yale.edu.
Karin NyströmDivision of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Emergency Medicine, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
Hardik AminDivision of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Emergency Medicine, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
Joseph SchindlerDepartment of Neurology, Yale School of Medicine, 15 York Street, LCI 10, New Haven, CT, 06510, USA.
Charles WiraDepartment of Neurology, Yale School of Medicine, 15 York Street, LCI 10, New Haven, CT, 06510, USA.
David GreerDepartment of Neurology, Yale School of Medicine, 15 York Street, LCI 10, New Haven, CT, 06510, USA.
Nai Fang ChiDepartment of Neurology, Taipei Medical University Hospital and Shuang Ho Hospital, Taipei, Taiwan.
Janet HallidayDivision of Vascular Neurology, Division of Neurocritical Care and Emergency Neurology, Yale Department of Emergency Medicine, Yale Department of Neurology, Yale-New Haven Hospital, New Haven, CT, USA.
Kevin N ShethDepartment of Neurology, Yale School of Medicine, 15 York Street, LCI 10, New Haven, CT, 06510, USA. kevin.sheth@yale.edu.
Yale New Haven Hospital · USYale University · USTaipei Medical University-Shuang Ho Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSymptomatic intracranial hemorrhage (sICH) is a serious complication of IV rt-PA therapy after acute ischemic stroke. Independent sICH predictors have been previously derived using case-control studies. Here we utilized a novel cohort-based comparison to identify additional independent predictors of sICH.

methodsWe included 210 patients receiving IV rt-PA therapy from January 2009 through December 2013 at the Yale-New Haven Stroke Center. Clinical parameters were compared using Mann-Whitney tests, two-sample tests of proportions and two-sample t tests. Logistic regression was performed using sICH as the dependent variable. Predictive ability was assessed using areas under the receiver operating characteristic (ROC) curve.

resultssICH rates were lowest from 2010 to 2012 and comprised the low sICH cohort (2.0 % sICH), compared to the high sICH cohort from 2009 to 2013 (9.2 % sICH, P = 0.025). Patients in the low sICH cohort had significantly more visual field deficits (38.6 vs. 24.8 %, P = 0.03) and decreased levels of consciousness (62.4 vs. 39.4 %, P < 0.001), but fewer hyperdense MCA signs (5 vs. 13.8 %, P = 0.03) and early CT hypodensities (14.9 vs. 29.4 %, P = 0.01). These four parameters together predicted sICH modestly (area under ROC curve 0.66, odds ratio 2.72, P = 0.03)

conclusionsUsing a novel cohort-based approach, we identified two new independent predictors of sICH after IV rt-PA therapy: the presence of the hyperdense MCA sign and early CT hypodensities. Novel methods are needed to reduce the risk of sICH for patients receiving antithrombolytic therapy for ischemic stroke.

Indexed as

Cerebral HemorrhageOutcome Assessment, Health CareStrokeAdministration, IntravenousAgedFemaleFibrinolytic AgentsHumansMaleMiddle Cerebral ArteryPrognosisRadiographyRetrospective StudiesThrombolytic TherapyTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen ActivatorIntracerebral hemorrhageIV ThrombolysisNeurocritical care

Identifiers

PMID25691004
OpenAlexW1982611095

What OpenQuestion holds

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Registered trials

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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.