Evidence map›Paper›PMID 31848737›Full record

ArticleJournal of neurology2020

Optimization of risk stratification for anticoagulation-associated intracerebral hemorrhage: net risk estimation.

Vasileios-Arsenios Lioutas, Nitin Goyal, Aristeidis H Katsanos, Christos Krogias, Ramin Zand, Vijay K Sharma, Panayiotis Varelas, Konark Malhotra, Maurizio Paciaroni, Theodore Karapanayiotides and 15 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Article
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

25 authors at 16 institutions in 6 countries.

Vasileios-Arsenios LioutasDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA. vlioutas@bidmc.harvard.edu.ORCID http://orcid.org/0000-0002-8521-0036
Nitin GoyalDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
Aristeidis H KatsanosDepartment of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada.
Christos KrogiasDepartment of Neurology, St. Josef-Hospital, Ruhr University of Bochum, Bochum, Germany.
Ramin ZandDepartment of Neurology, Geisinger Medical Center, Danville, PA, USA.
Vijay K SharmaDivision of Neurology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Panayiotis VarelasDepartment of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Konark MalhotraDepartment of Neurology, Allegheny Health Network, Pittsburgh, PA, USA.
Maurizio PaciaroniStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Theodore KarapanayiotidesSecond Department of Neurology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Aboubakar SharafDepartment of Neurology, Essentia Health-Duluth Clinic, Duluth, MN, USA.
Jason ChangDepartment of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA.
Odysseas KargiotisAcute Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
Abhi PandhiDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
Lina PalaiodimouSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Christoph SchroederDepartment of Neurology, St. Josef-Hospital, Ruhr University of Bochum, Bochum, Germany.
Argyrios TsantesLaboratory of Haematology and Blood Bank Unit (A.T.), School of Medicine, "Attikon" Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Efstathios BoviatsisSecond Department of Neurosurgery, School of Medicine, "Attikon University Hospital", National and Kapodistrian University of Athens, Athens, Greece.
Chandan MehtaDepartment of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Aspasia SerdariDepartment of Child and Adolescent Psychiatry, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Konstantinos VadikoliasDepartment of Neurology, School of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Panayiotis D MitsiasDepartment of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Magdy H SelimDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Andrei V AlexandrovDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
Georgios TsivgoulisDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
University of Tennessee Health Science Center · USNational and Kapodistrian University of Athens · GRBeth Israel Deaconess Medical Center · USDemocritus University of Thrace · GRHenry Ford Hospital · USSt. Josef-Hospital · DEAllegheny Health Network · USAristotle University of Thessaloniki · GREssentia Health · USGeisinger Medical Center · USMedStar Washington Hospital Center · USMetropolitan Hospital · GRNational University of Singapore · SGPopulation Health Research Institute · CAUniversity of Crete · GRUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvery anticoagulation decision has in inherent risk of hemorrhage; intracerebral hemorrhage (ICH) is the most devastating hemorrhagic complication. We examined whether combining ischemic and hemorrhagic stroke risk in individual patients might provide a meaningful paradigm for risk stratification.

methodsWe enrolled consecutive patients with anticoagulation-associated ICH in 15 tertiary centers in the USA, Europe and Asia between 2015 and 2017. Each patient was assigned baseline ischemic stroke and hemorrhage risk based on their CHA

resultsWe enrolled 357 patients [59% men, median age 76 (68-82) years]. 31% used non-vitamin K antagonist (NOAC). 191 (53.5%) patients had a favorable indication for anticoagulation prior to their ICH; 166 (46.5%) unfavorable. Those with unfavorable indication were younger [72 (66-80) vs 78 (73-84) years, p = 0.001], with lower CHA

conclusionsIn this anticoagulation-associated ICH cohort, baseline hemorrhagic risk exceeded ischemic risk in approximately 50%, highlighting the importance of careful consideration of risk/benefit ratio prior to anticoagulation decisions. The remaining 50% suffered an ICH despite excess baseline ischemic risk, stressing the need for biomarkers to allow more precise estimation of hemorrhagic complication risk.

Indexed as

Severity of Illness IndexAgedAged, 80 and overAnticoagulantsCerebral HemorrhageCohort StudiesFemaleHumansIschemic StrokeMaleRisk AssessmentAnticoagulantsAnticoagulantsAtrial fibrillationIntracerebral hemorrhageRisk assessment

Identifiers

PMID31848737
OpenAlexW2994870492

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.