Evidence map›Paper›PMID 33751446›Full record

Observational studyNeurocritical care2021

Prognostic Value of a Structural Brain MRI Score in the Acute Phase of Aneurysmal Subarachnoid Hemorrhage: A Pilot Study.

Sarah E Nelson, Pirouz Piran, Jun Hua, Alexander Sigmon, Casey Weiner, Haris I Sair, Jose I Suarez, Robert D Stevens

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurocritical care, 2021. 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
–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

2 citing papers in PubMed.

  1. Article
  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

8 authors.

Sarah E NelsonDepartment of Neurosurgery and Neurology, Mount Sinai West, 1000 10th Avenue, New York, NY, 10019, USA. senelson13@gmail.com.ORCID http://orcid.org/0000-0002-6026-2251
Pirouz PiranDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
Jun HuaDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.
Alexander SigmonDepartment of Neurosciences, Johns Hopkins University, Baltimore, MD, USA.
Casey WeinerDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Haris I SairDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.
Jose I SuarezDepartments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
Robert D StevensDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectiveAneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality despite advances in management. We evaluated the prognostic significance of a qualitative score using brain magnetic resonance imaging (MRI) features obtained early after aSAH.

methodsPatients with aSAH were enrolled in a prospective observational cohort and underwent brain MRI during their acute hospitalization. MRIs were rated using a scoring system that considers the anatomical location of signal intensity changes on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences. The relationship between MRI scores and functional outcome defined by modified Rankin scale (mRS) at 6 months was evaluated in uni- and multivariable models.

resultsThe cohort included 45 aSAH patients (median World Federation of Neurologic Surgeons (IQR) 2 (1-4)) who underwent brain MRI a mean (SD) of 9.0 ± 8.0 days after aSAH. At 6 months after aSAH, 26 patients had achieved a favorable outcome (mRS ≤ 2) while 15 had an unfavorable outcome (mRS > 2). Deep gray nuclei (DGN) score (p = 0.016), cortex + DGN score (p = 0.015), FLAIR score (p = 0.016), DWI score (p = 0.0045), and overall score (p = 0.0081) were significantly lower in patients with favorable outcome compared to those with unfavorable outcome. However, MRI scores were not independent predictors of outcome in multivariable models adjusting for admission Hunt and Hess, Glasgow Coma Scale, or World Federation of Neurologic Surgeons scales.

conclusionsIn this pilot study, a qualitative scoring system using anatomically defined MRI FLAIR and DWI signal abnormalities identified in the acute phase of aSAH was linked to 6-month functional outcome. However, these scores did not add prognostic value to established indices of neurological severity.

Indexed as

Subarachnoid HemorrhageBrainHumansMagnetic Resonance ImagingPilot ProjectsPrognosisAneurysmal subarachnoid hemorrhageMagnetic resonance imagingPrognosis

Identifiers

PMID33751446

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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.