Evidence map›Paper›PMID 35099712›Full record

ArticleNeurocritical care2022

Conditional Vasospasm-Free Survival Following Aneurysmal Subarachnoid Hemorrhage.

Patrick D Kelly, Aaron M Yengo-Kahn, Alan R Tang, Sumeeth V Jonathan, Rebecca A Reynolds, Fei Ye, Zhiguo Zhao, Michael T Froehler, Matthew R Fusco, Peter J Morone and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurocritical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. 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

11 authors at 3 institutions in 1 country.

Patrick D KellyDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA. patrick.d.kelly@vumc.org.ORCID http://orcid.org/0000-0003-4911-4239
Aaron M Yengo-KahnDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Alan R TangVanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA.
Sumeeth V JonathanVanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA.
Rebecca A ReynoldsDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Fei YeDepartment of Biostatistics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA.
Zhiguo ZhaoDepartment of Biostatistics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA.
Michael T FroehlerDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Matthew R FuscoDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Peter J MoroneDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Rohan V ChitaleDepartment of Neurological Surgery, Vanderbilt University Medical Center, Vanderbilt University Medical Center, North T-4224, 1161 21st Avenue South , Nashville, TN, 37212, USA.
Neurological Surgery · USVanderbilt University · USVanderbilt University Medical Center · US

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Surgical Oncology Training GrantT32CA106183 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI James Richard Goldenring · 2004 to 2026
$6.0M
NCATS NIH HHS UL1 TR000445NCI NIH HHS T32 CA106183
6 · The paper itself

Abstract

backgroundFollowing aneurysmal subarachnoid hemorrhage (SAH), patients are monitored closely for vasospasm in the intensive care unit. Conditional vasospasm-free survival describes the risk of future vasospasm as a function of time elapsed without vasospasm. Conditional survival has not been applied to this clinical scenario but could improve patient counseling and intensive care unit use. The objective of this study was to characterize conditional vasospasm-free survival following SAH.

methodsThis was a single institution, retrospective cohort study of patients treated for aneurysmal SAH between 1/1/2000-6/1/2020. The primary outcome was the development of vasospasm defined by the first instance of either radiographic vasospasm on computed tomography angiography, Lindegaard Index > 3.0 by transcranial doppler ultrasonography, or vasospasm-specific intraarterial therapy. Multivariable Cox regression was performed, and conditional vasospasm-free survival curves were constructed.

resultsA total of 528 patients were treated for aneurysmal SAH and 309 (58.5%) developed vasospasm. Conditional survival curves suggest patients who survive to postbleed day 10 without vasospasm have a nearly 90% chance of being discharged without vasospasm. The median onset of vasospasm was postbleed day 6. Age more than 50 years was associated with a lower risk (hazard ratio [HR] = .76; 95% confidence interval [CI] 0.64-0.91; p < 0.001). Higher initial systolic blood pressure (HR = 1.18; 95% CI 1.046-1.350; p = .008), Hunt-Hess grades 4 or 5 (HR = 1.304; 95% CI 1.014-1.676), and modified Fisher scale score of 4 (HR = 1.808; 95% CI 1.198-2.728) were associated with higher vasospasm than the respective lower grades.

conclusionConditional survival provides a useful framework for counseling patients and making decisions around vasospasm risk for patients with aneurysmal SAH, while risk factor-stratified plots facilitate a patient-centric, evidence-based approach to these conversations and decisions.

Indexed as

Autonomic Nervous System DiseasesSubarachnoid HemorrhageVasospasm, IntracranialHumansMiddle AgedRetrospective StudiesRisk FactorsUltrasonography, Doppler, TranscranialIntensive care unitsIntracranial vasospasmSubarachnoid hemorrhageSurvival analysis

Identifiers

PMID35099712
PMCPMC10949213
OpenAlexW4210815524

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.