Evidence map›Paper›PMID 33752211›Full record

ArticleCerebrovascular diseases (Basel, Switzerland)2021

Cognitive Impairment after Lacunar Stroke and the Risk of Recurrent Stroke and Death.

Abraham Kwan, Jingkai Wei, N Maritza Dowling, Melinda C Power, Zurab Nadareishvili, SPS3 Study Group

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PubMed Full text at PMC Publisher
In one paragraph

Article in Cerebrovascular diseases (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 9% 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

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
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  11. Post-stroke cognitive impairment and the risk of stroke recurrence and death in patients with insulin resistance.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022
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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 at 2 institutions in 1 country.

Abraham KwanDepartment of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Jingkai WeiDepartment of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
N Maritza DowlingDepartment of Acute and Chronic Care, School of Nursing, George Washington University, Washington, District of Columbia, USA.
Melinda C PowerDepartment of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Zurab NadareishviliDepartment of Neurology, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA, nadareiz@gmail.com.
SPS3 Study Group
George Washington University · USMilken Institute · US

Funding

Telerehabilitation for Patients with StrokeU01NS091951 · NINDS · UNIVERSITY OF CALIFORNIA-IRVINE · PI CRAMER, STEVEN C. · 2014 to 2018
$2.6M
SECONDARY PREVENTION IN SMALL SUBCORTICAL STROKES (SPS3)R01NS038529 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR SAN ANT · PI BENAVENTE, OSCAR R · 1999 to 2001
$978k
NINDS NIH HHS R01 NS038529NINDS NIH HHS U01 NS091951
6 · The paper itself

Abstract

introductionPatients with poststroke cognitive impairment appear to be at higher risk of recurrent stroke and death. However, whether cognitive impairment after lacunar stroke is associated with recurrent stroke and death remains unclear. We assessed whether global or domain-specific cognitive impairment after lacunar stroke is associated with recurrent stroke and death.

methodsWe considered patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial with a baseline cognitive exam administered in English by certified SPS3 personnel, 14-180 days after qualifying lacunar stroke. We considered a baseline score of ≤86 on the Cognitive Assessment Screening Instrument to indicate global cognitive impairment, <10 on the Clock Drawing on Command test to indicate executive function impairment, and domain-specific summary scores in the lowest quartile to indicate memory and nonmemory impairment. We used Cox proportional hazards models to estimate the association between poststroke cognitive impairment and subsequent risk of recurrent stroke and death.

resultsThe study included 1,528 participants with a median enrollment time of 62 days after qualifying stroke. During a mean follow-up of 3.9 years, 11.4% of participants had recurrent stroke and 8.2% died. In the fully adjusted models, memory impairment was independently associated with an increased risk of recurrent stroke (hazard ratio, 1.48; 95% confidence interval [95% CI]: 1.04-2.09) and death (hazard ratio, 1.87; 95% CI: 1.25-2.79). Global impairment (hazard ratio, 1.66; 95% CI: 1.06-2.59) and nonmemory impairment (hazard ratio, 1.74; 95% CI: 1.14-2.67) were associated with an increased risk of death. DISCUSSION/

conclusionAfter lacunar stroke, memory impairment was an independent predictor of recurrent stroke and death, while global and nonmemory impairment were associated with death. Cognitive screening in lacunar stroke may help identify populations at higher risk of recurrent stroke and death.

Indexed as

CognitionMemoryAgedCause of DeathCognitive DysfunctionFemaleHumansMaleMemory DisordersMiddle AgedNeuropsychological TestsPredictive Value of TestsPrognosisRandomized Controlled Trials as TopicRecurrenceRisk AssessmentCognitive impairmentCognitive testingCohort studyLacunar stroke

Identifiers

PMID33752211
PMCPMC8266725
OpenAlexW3138018322

What OpenQuestion holds

Textmetadata
LicenceTDM
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.