Evidence map›Paper›PMID 34218182›Full record

ArticleJournal of the neurological sciences2021

Predicting short and long-term mortality after acute ischemic stroke using EHR.

Vida Abedi, Venkatesh Avula, Seyed-Mostafa Razavi, Shreya Bavishi, Durgesh Chaudhary, Shima Shahjouei, Ming Wang, Christoph J Griessenauer, Jiang Li, Ramin Zand

Abstract read
In one paragraph

Article in Journal of the neurological sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
–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

28 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

10 authors.

Vida AbediDepartment of Molecular and Functional Genomics, Geisinger, Danville, PA, United States; Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States. Electronic address: vidaabedi@gmail.com.
Venkatesh AvulaDepartment of Molecular and Functional Genomics, Geisinger, Danville, PA, United States. Electronic address: vavula1@geisinger.edu.
Seyed-Mostafa RazaviHeart and Rhythm Clinic, San Jose, CA, United States. Electronic address: razavi.mos@gmail.com.
Shreya BavishiAMC MET Medical College, Gujarat University, Ahmedabad, India. Electronic address: bavishi.shreya@gmail.com.
Durgesh ChaudharyGeisinger Neuroscience Institute, Geisinger, Danville, PA, United States. Electronic address: dpchaudhary@geisinger.edu.
Shima ShahjoueiGeisinger Neuroscience Institute, Geisinger, Danville, PA, United States. Electronic address: sshahjouei@geisinger.edu.
Ming WangDepartment of Public Health Sciences, Penn State Cancer Institute, PA, United States. Electronic address: mwang@phs.psu.edu.
Christoph J GriessenauerGeisinger Neuroscience Institute, Geisinger, Danville, PA, United States; Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria. Electronic address: christoph.griessenauer@gmail.com.
Jiang LiDepartment of Molecular and Functional Genomics, Geisinger, Danville, PA, United States. Electronic address: jli@geisinger.edu.
Ramin ZandGeisinger Neuroscience Institute, Geisinger, Danville, PA, United States. Electronic address: ramin.zand@gmail.com.

Funding

Electronic Health Record Data and Predictive Analytic Methods for HFR56HL116832 · NHLBI · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI YAN, XIAOWEI SHERRY · 2018 to 2018
$761k
NHLBI NIH HHS R56 HL116832
6 · The paper itself

Abstract

objectiveDespite improvements in treatment, stroke remains a leading cause of mortality and long-term disability. In this study, we leveraged administrative data to build predictive models of short- and long-term post-stroke all-cause-mortality.

methodsThe study was conducted and reported according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guideline. We used patient-level data from electronic health records, three algorithms, and six prediction windows to develop models for post-stroke mortality.

resultsWe included 7144 patients from which 5347 had survived their ischemic stroke after two years. The proportion of mortality was between 8%(605/7144) within 1-month, to 25%(1797/7144) for the 2-years window. The three most common comorbidities were hypertension, dyslipidemia, and diabetes. The best Area Under the ROC curve(AUROC) was reached with the Random Forest model at 0.82 for the 1-month prediction window. The negative predictive value (NPV) was highest for the shorter prediction windows - 0.91 for the 1-month - and the best positive predictive value (PPV) was reached for the 6-months prediction window at 0.92. Age, hemoglobin levels, and body mass index were the top associated factors. Laboratory variables had higher importance when compared to past medical history and comorbidities. Hypercoagulation state, smoking, and end-stage renal disease were more strongly associated with long-term mortality.

conclusionAll the selected algorithms could be trained to predict the short and long-term mortality after stroke. The factors associated with mortality differed depending on the prediction window. Our classifier highlighted the importance of controlling risk factors, as indicated by laboratory measures.

Indexed as

Brain IschemiaIschemic StrokeStrokeHumansMachine LearningROC CurveArtificial intelligenceEHRElectronic health recordIschemic strokeMachine learningMortalityOutcome prediction

Identifiers

PMID34218182
PMCPMC8480306

What OpenQuestion holds

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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.