Evidence map›Paper›PMID 35761128›Full record

ArticleNeurocritical care2022

The Spot Sign and Intraventricular Hemorrhage are Associated with Baseline Coagulopathy and Outcome in Intracerebral Hemorrhage.

Sung-Ho Ahn, Jeong-Ho Hong, Glenda L Torres, Jude P Savarraj, Chang Hyeun Kim, Young Ha Kim, Arthur L Day, H Alex Choi, James C Grotta, Kiwon Lee and 1 more

Abstract read
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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 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 39% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Review
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 4 institutions in 2 countries.

Sung-Ho AhnDepartment of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Jeong-Ho HongDepartment of Neurology, School of Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea.
Glenda L TorresDivision of Neurocritical Care, Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Jude P SavarrajDivision of Neurocritical Care, Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Chang Hyeun KimDepartment of Neurosurgery, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, and Pusan National University Yangsan Hospital, Pusan, South Korea.
Young Ha KimDepartment of Neurosurgery, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, and Pusan National University Yangsan Hospital, Pusan, South Korea.
Arthur L DayDivision of Neurocritical Care, Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
H Alex ChoiDivision of Neurocritical Care, Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
James C GrottaDepartment of Neurology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Kiwon LeeDivision of Neuroendovascular Surgery and Neurocritical Care, Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
Tiffany R ChangDivision of Neurocritical Care, Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA. Tiffany.R.Chang@uth.tmc.edu.
The University of Texas Health Science Center at Houston · USPusan National University Yangsan Hospital · KRKeimyung University Dongsan Medical Center · KRRutgers, The State University of New Jersey · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpontaneous intracerebral hemorrhage (ICH) is the second most prevalent subtype of stroke and has high mortality and morbidity. The utility of radiographic features to predict secondary brain injury related to hematoma expansion (HE) or increased intracranial pressure has been highlighted in patients with ICH, including the computed tomographic angiography (CTA) spot sign and intraventricular hemorrhage (IVH). Understanding the pathophysiology of spot sign and IVH may help identify optimal therapeutic strategies. We examined factors related to the spot sign and IVH, including coagulation status, hematoma size, and location, and evaluated their prognostic value in patients with ICH.

methodsProspectively collected data from a single center between 2012 and 2015 were analyzed. Patients who underwent thromboelastography within 24 h of symptom onset and completed follow-up brain imaging and CTA within 48 h after onset were included for analysis. Multivariate logistic regression analyses were performed to identify determinants of the spot sign and IVH and their predictive value for HE, early neurological deterioration (END), in-hospital mortality, and functional outcome at discharge.

resultsOf 161 patients, 50 (31.1%) had a spot sign and 93 (57.8%) had IVH. In multivariable analysis, the spot sign was associated with greater hematoma volume (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03), decreased white blood cell count (OR 0.88; 95% CI 0.79-0.98), and prolonged activated partial thromboplastin time (OR 1.14; 95% CI 1.06-1.23). IVH was associated with greater hematoma volume (OR 1.02; 95% CI 1.01-1.04) and nonlobar location of hematoma (OR 0.23; 95% CI 0.09-0.61). The spot sign was associated with greater risk of all adverse outcomes. IVH was associated with an increased risk of END and reduced HE, without significant impact on mortality or functional outcome.

conclusionsThe spot sign and IVH are associated with specific hematoma characteristics, such as size and location, but are related differently to coagulation status and clinical course. A combined analysis of the spot sign and IVH can improve the understanding of pathophysiology and risk stratification after ICH.

Indexed as

Blood Coagulation DisordersStrokeCerebral AngiographyCerebral HemorrhageComputed Tomography AngiographyHematomaHumansPredictive Value of TestsTomography, X-Ray ComputedEarly neurological deteriorationHematoma expansionIntracerebral hemorrhageIntraventricular hemorrhageOutcomeSpot sign

Identifiers

PMID35761128
OpenAlexW4283700326

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.