Evidence map›Paper›PMID 35279071›Full record

ArticleBMC medical imaging2022

Prediction of midline shift after media ischemia using computed tomography perfusion.

Sebastian Johannes Müller, Eya Khadhraoui, Marielle Sophie Ernst, Christian Heiner Riedel

Open access · goldAbstract read
In one paragraph

Article in BMC medical imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
–field-weighted citation impact, top 96% 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

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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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

4 authors at 1 institution in 1 country.

Sebastian Johannes Müller *Department of Neuroradiology, University Hospital Göttingen, Georg-August-University, Göttingen, Germany. sebastian.mueller@med.uni-goettingen.de.
Eya Khadhraoui *Department of Neuroradiology, University Hospital Göttingen, Georg-August-University, Göttingen, Germany.
Marielle Sophie ErnstDepartment of Neuroradiology, University Hospital Göttingen, Georg-August-University, Göttingen, Germany.
Christian Heiner RiedelDepartment of Neuroradiology, University Hospital Göttingen, Georg-August-University, Göttingen, Germany.
University of Göttingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDecision-making about the indication for decompressive hemicraniectomy in cases with malignant infarction in the territory of the middle cerebral artery (MCA) is still a matter of debate. Some scores have been introduced and tested, most of them are midline-shift dependent. We introduce the Kinematics of malignant MCA infarction (KM) index, which can be calculated based on an initial computed tomography perfusion scan and the chosen therapy (lysis/thrombectomy/conservative) in order to estimate the maximum midline-shift in the subsequent 6 days.

methodsWe retrospectively analyzed patients with middle cerebral artery infarction who had a non-enhanced computed tomography (CT) scan, CT angiography and a CT perfusion scan in the acute setting and who presented in our emergency room between 2015 and 2019. 186 patients were included. Midline shift was measured on follow-up imaging between days 0 and 6 after stroke. We evaluated Pearson's correlation between the KM index and the amount of midline shift.

resultsThe mean KM index of all patients was 1.01 ± 0.09 (decompressive hemicraniectomy subgroup 1.13 ± 0.13; midline shift subgroup 1.18 ± 0.13). The correlation coefficient between the KM index and substantial midline-shift was 0.61, p < 0.01 and between KM index and decompressive hemicraniectomy or death 0.47; p < 0.05. KM index > 1.02 shows a sensitivity of 92% (22/24) and a specificity of 78% (126/162) for detecting midline shifts. The area under curve of the receiver operator characteristics was 91% for midline shifts and 86% for the occurrence of decompressive hemicraniectomy or death.

conclusionIn this retrospective study, KM index shows a strong correlation with significant midline-shift. The KM index can be used for risk classification regarding herniation and the need of decompressive hemicraniectomy.

Indexed as

Decompressive CraniectomyHumansInfarction, Middle Cerebral ArteryPerfusionRetrospective StudiesTomography, X-Ray ComputedTreatment OutcomeDHCHemicraniectomyKM indexMedia ischemiaPerfusion

Identifiers

PMID35279071
PMCPMC8918336
OpenAlexW4220955020

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Registered trials

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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.