Evidence map›Paper›PMID 35703094›Full record

SynthesisStroke2022

Functional Outcomes of Patients ≥85 Years With Acute Ischemic Stroke Following EVT: A HERMES Substudy.

Rosalie V McDonough, Johanna M Ospel, Bruce C V Campbell, Michael D Hill, Jeffrey L Saver, Diederik W J Dippel, Andrew M Demchuk, Charles B L M Majoie, Scott B Brown, Peter J Mitchell and 7 more

Open access · bronzeAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
7.3field-weighted citation impact, top 2% 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

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

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  11. Utility of AActa neurologica Belgica · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 13 institutions in 10 countries.

Rosalie V McDonough *Department of Diagnostic Imaging (R.V.M., J.M.O.), Foothills Medical Center, University of Calgary, AB, Canada.ORCID 0000-0002-8060-4490
Johanna M Ospel *Department of Diagnostic Imaging (R.V.M., J.M.O.), Foothills Medical Center, University of Calgary, AB, Canada.ORCID 0000-0003-0029-6764
Bruce C V CampbellDepartment of Medicine and Neurology, Melbourne Brain Centre, Australia (B.C.V.C.).ORCID 0000-0003-3632-9433
Michael D HillDepartment of Clinical Neurosciences (M.D.H., A.M.D., M.G.), Foothills Medical Center, University of Calgary, AB, Canada.
Jeffrey L SaverDepartment of Neurology, University of California Los Angeles Medical Center (J.L.S.).ORCID 0000-0001-9141-2251
Diederik W J DippelDepartment of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands (D.W.J.D.).ORCID 0000-0002-9234-3515
Andrew M DemchukDepartment of Clinical Neurosciences (M.D.H., A.M.D., M.G.), Foothills Medical Center, University of Calgary, AB, Canada.ORCID 0000-0002-4930-7789
Charles B L M MajoieDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands (C.B.L.M.M.).ORCID 0000-0002-7600-9568
Scott B BrownBRIGHT Research Partners, Inc, Mooresville, NC (S.B.B.).
Peter J MitchellDepartment of Radiology, Royal Melbourne Hospital, University of Melbourne, Australia (P.J.M.).ORCID 0000-0002-8337-7529
Serge BracardDepartment of Diagnostic and Interventional Neuroradiology (S.B.), University of Lorraine and University Hospital of Nancy, France.
Francis GuilleminDepartment of Clinical Epidemiology (F.G.), University of Lorraine and University Hospital of Nancy, France.ORCID 0000-0002-9860-7024
Tudor G JovinDepartment of Neurology, Stroke Institute, University of Pittsburgh Medical Center Stroke Institute, Presbyterian University Hospital, PA (T.G.J.).ORCID 0000-0002-2619-6975
Keith W MuirInstitute of Neuroscience and Psychology, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, United Kingdom (K.W.M.).
Philip WhiteInstitute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
Mayank GoyalDepartment of Clinical Neurosciences (M.D.H., A.M.D., M.G.), Foothills Medical Center, University of Calgary, AB, Canada.
HERMES Collaborators
Foothills Medical Centre · CAAllen Institute for Brain Science · USAmsterdam University Medical Centers · NLCentre Hospitalier Régional et Universitaire de Nancy · FRErasmus MC · NLLos Angeles Medical Center · USNewcastle University · GBPartners In Care · USQueen Elizabeth University Hospital · GBThe Royal Melbourne Hospital · AUUniversität Hamburg · DEUniversité de Lorraine · FRUPMC Presbyterian · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObservational studies have shown endovascular treatment (EVT) for acute ischemic stroke to be effective in the elderly, despite resulting in poorer outcomes and higher rates of mortality compared with younger patients. Randomized data on the effect of advanced age on outcomes following EVT are, however, lacking. Our aim was to assess the EVT effect for ischemic stroke in patients aged ≥85 years and the influence of age on outcome in a large, randomized trial dataset.

methodsData were from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration, a meta-analysis of 7 randomized trials published between January 1, 2010, and May 31, 2017, that tested the efficacy of EVT. A possible multiplicative interaction effect of age on the relationship between treatment and outcome was investigated. Ordinal logistic regression tested the association between EVT and 90-day functional outcome (modified Rankin Scale, primary outcome) in patients ≥85 years. Multivariable binary logistic regression was performed to compare primary and secondary outcomes (modified Rankin Scale score of 0-2/5-6) of patients ≥85 years versus those <85 years.

resultsWe included 1764 patients in the analysis, of whom 77 (4.4%) were ≥85 years old. A significant interaction of age and treatment on poor outcome (modified Rankin Scale score of 5-6,

conclusionsPatients ≥85 years old with independent premorbid function more often achieve good functional outcomes and have lower rates of mortality when treated with EVT compared with conservative management, with an observed treatment effect modification of age on outcome. EVT should therefore not be withheld in this subgroup.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeAgedAged, 80 and overHumansThrombectomyTreatment Outcomeageischemic strokemortalityreperfusion

Identifiers

PMID35703094
OpenAlexW4282972975

What OpenQuestion holds

Textmetadata
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.