ArticleStroke and vascular neurology2020
Inconsistent centralised versus non-centralised ischaemic stroke aetiology.
Article in Stroke and vascular neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 24 citations in OpenAlex.
- TheJournal of the American Heart Association · 2026Article
- Associations between admission levels of multiple biomarkers and subsequent worse outcomes in acute ischemic stroke patients.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Trends of Sex Differences and Associated Factors in Stroke Outcomes Among Patients With Acute Ischemic Stroke: 2007 to 2018Neurology · 2024Article
- TOAST stroke subtype classification in clinical practice: implications for the Get With The Guidelines-Stroke nationwide registry.Frontiers in neurology · 2024Article
- Cardiac thrombus detected by cardiac computed tomography angiography in patients with acute ischemic stroke: a meta-analysis.Frontiers in neurology · 2024Article
- Predictive Role of hsCRP in Recurrent Stroke Differed According to Severity of Cerebrovascular Disease: Analysis from a Prospective Cohort Study.Journal of clinical medicine · 2023Article
- Distribution and prognosis of acute ischaemic stroke with negative diffusion-weighted imaging.Stroke and vascular neurology · 2022Article
- Data-driven clustering approach to identify novel phenotypes using multiple biomarkers in acute ischaemic stroke: A retrospective, multicentre cohort study.EClinicalMedicine · 2022Article
- Association Between High-Sensitivity C-Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack.Journal of the American Heart Association · 2022Article
- Interleukin-6 and YKL-40 predicted recurrent stroke after ischemic stroke or TIA: analysis of 6 inflammation biomarkers in a prospective cohort study.Journal of neuroinflammation · 2022Article
- Use of Prolonged Cardiac Rhythm Monitoring to Identify Atrial Fibrillation After Cryptogenic Stroke.Current cardiology reports · 2022Review
- Causative Classification of Ischemic Stroke by the Machine Learning Algorithm Random Forests.Frontiers in aging neuroscience · 2022Article
- Association of Polyvascular Disease and Elevated Interleukin-6 With Outcomes in Acute Ischemic Stroke or Transient Ischemic Attack.Frontiers in neurology · 2021Article
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe Trial of Org 10 172 in Acute Stroke Treatment (TOAST) system is the most widely used aetiological categorisation system in clinical practice and research. Limited studies have validated the accuracy of routine aetiological diagnosis of patients with ischaemic stroke according to the TOAST criteria when the reported subtype is assumed to be correct. We investigated the agreement between centralised and non-centralised (site-reported, at discharge) stroke subtypes in the Third China National Stroke Registry (CNSR-III), and analysed the influence of classification consistency on evaluation during hospitalisation and for secondary prevention strategy.
methodsAll patients with ischaemic stroke from the CNSR-III study with complete diffusion-weighted imaging data were included. We used multivariable Cox proportional-hazard regression models to evaluate the factors associated with consistency between centralised and non-centralised stroke subtypes. Sensitivity analyses were conducted of the subgroup of patients with complete information.
resultsThis study included 12 180 patients (mean age, 62.3 years; and women, 31.4%). Agreement between centralised and non-centralised subtype was the highest for the large-artery atherosclerosis subtype stroke (77.4% of centralised patients), followed by the small-vessel occlusion subtype (40.6% of centralised patients). Agreements for cardioembolism and stroke of other determined aetiology subtypes were 38.7% and 12.2%, respectively. Patient-level and hospital-level factors were associated with the inconsistency between centralised/non-centralised aetiological subtyping. This inconsistency was related to differences in secondary prevention strategies. Only 15.3% of the newly diagnosed patients with cardioembolism underwent centralised subtyping with indications to receive oral anticoagulants at discharge. In comparison, 51.3% of the consistent cardioembolism group and 42.0% of the centrally reassigned cardioembolism group with anticoagulation indications were prescribed oral anticoagulants.
conclusionsSubstantial inconsistency exists between centralised and non-centralised subtyping in China. Inaccurate aetiological subtyping could lead to inadequate secondary prevention, especially in patients with cardioembolic stroke.
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