Evidence map›Paper›PMID 35922890›Full record

ArticleJournal of neuroimaging : official journal of the American Society of Neuroimaging2022

Chronic cerebral infarctions and white matter lesions link to long-term survival after a first ischemic event: A cohort study.

Marina Schilter, Alessandra Epstein, Jan Vynckier, Adnan Mujanovic, Nebiyat Filate Belachew, Morin Beyeler, Bernhard Siepen, Martina Goeldlin, Adrian Scutelnic, David Julian Seiffge and 7 more

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

Article in Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-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, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Chronic cerebral infarctions and white matter lesions link to long-term survival after a first ischemic event: A cohort study.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2022
    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

17 authors at 2 institutions in 1 country.

Marina SchilterDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Alessandra EpsteinDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jan VynckierDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Adnan MujanovicInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Nebiyat Filate BelachewInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Morin BeyelerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Bernhard SiepenDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Martina GoeldlinDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Adrian ScutelnicDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
David Julian SeiffgeDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Simon JungDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jan GrallaInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Tomas DobrockyInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Johannes KaesmacherInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, Basel University Hospital, University of Basel, Bern, Switzerland.
Thomas Raphael MeinelDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-0647-9273
University of Bern · CHUniversity of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeTo investigate the association of different phenotypes, count, and locations of chronic covert brain infarctions (CBI) with long-term mortality in patients with first-ever manifest acute ischemic stroke (AIS) or transient ischemic attack (TIA). Additionally, to analyze their potential interaction with white matter hyperintensities (WMH) and predictive value in addition to established mortality scores.

methodsSingle-center cohort study including consecutive patients with first-ever AIS or TIA with available MRI imaging from January 2015 to December 2017. Blinded raters adjudicated CBI phenotypes and WMH (age-related white matter changes score) according to established definitions. We compared Cox regression models including prespecified established predictors of mortality using Harrell's C and likelihood ratio tests.

resultsA total of 2236 patients (median [interquartile range] age: 71 [59-80] years, 43% female, National Institutes of Health Stroke Scale: 2 [1-6], median follow-up: 1436 days, 21% death during follow-up) were included. Increasing WMH (per point adjusted Hazard Ratio [aHR] = 1.29 [1.14-1.45]), but not CBI (aHR = 1.21 [0.99-1.49]), were independently associated with mortality. Neither CBI phenotype, count, nor location was associated with mortality and there was no multiplicative interaction between CBI and WMH (p > .1). As compared to patients without CBI or WMH, patients with moderate or severe WMH and additional CBI had the highest hazards of death (aHR = 1.62 [1.23-2.13]). The Cox regression model including CBI and WMH had a small but significant increment in Harrell's C when compared to the model including 14 clinical variables (0.831 vs. 0.827, p < .001). DISCUSSION: WMH represent a strong surrogate biomarker of long-term mortality in first-ever manifest AIS or TIA patients. CBI phenotypes, count, and location seem less relevant. Incorporation of CBI and WMH slightly improves predictive capacity of established risk scores.

Indexed as

Brain IschemiaIschemic Attack, TransientIschemic StrokeLeukoaraiosisStrokeWhite MatterCerebral InfarctionCohort StudiesFemaleHumansMagnetic Resonance ImagingMaleacute ischemic strokecovert brain infarctionmortalityTIAwhite matter hyperintensities

Identifiers

PMID35922890
PMCPMC9804158
OpenAlexW4289711079

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.