Evidence map›Paper›PMID 37591777›Full record

Trial reportNeurology2023

Association of Brain Atrophy With Functional Outcome and Recovery Trajectories After Thrombectomy: Post Hoc Analysis of the ESCAPE-NA1 Trial.

Faysal Benali, Joachim Fladt, Tanaporn Jaroenngarmsamer, Fouzi Bala, Nishita Singh, Johanna Maria Ospel, Michael Tymianski, Michael D Hill, Mayank Goyal, Aravind Ganesh

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

Trial report in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
3.6field-weighted citation impact, top 6% 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

14 citing papers in PubMed, 17 citations in OpenAlex.

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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

10 authors at 1 institution in 3 countries.

Faysal BenaliFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Joachim FladtFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Tanaporn JaroenngarmsamerFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.ORCID 0000-0003-0689-7392
Fouzi BalaFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.ORCID 0000-0001-6748-2081
Nishita SinghFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Johanna Maria OspelFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Michael TymianskiFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Michael D HillFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.ORCID 0000-0002-6269-1543
Mayank GoyalFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada.
Aravind GaneshFrom the Maastricht University Medical Center+ (MUMC+) (F. Benali); Calgary Stroke Program (F. Benali, J.F., T.J., F. Bala, N.S., J.M.O., M.D.H., M.G., A.G.), Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine; and NoNO (M.T.), Toronto, ON, Canada. aganesh@ucalgary.ca.ORCID 0000-0001-5520-2070
University of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesBrain frailty may impair the ability of acute stroke patients to cope with the injury, irrespective of their chronologic age, resulting in impaired recovery. We aim to investigate the impact of brain atrophy on functional outcome assessed at different time points after endovascular thrombectomy (EVT).

methodsIn this retrospective post hoc analysis of the ESCAPE-NA1 trial, we analyzed CT imaging data for cortical atrophy by using the GCA scale, including region-specific scales, and subcortical atrophy by using the intercaudate distance to inner table width (CC/IT) ratio. The primary outcome was 90-day mRS (ordinal shift analysis), and the secondary outcome was the mRS score over time. Adjustments were made for age, sex, baseline NIHSS, final infarct volume, stroke laterality, total Fazekas score, and nerinetide-alteplase interaction. Sensitivity analyses were additionally performed in only those patients for whom MRI data were available.

resultsOf 1,102 participants (mean age of 69.5 ± 13.7 years; 554 men), 818 (74%) had GCA = 0, 220 (20%) had GCA = 1, and 64 (6%) had GCA = 2/3. The median CC/IT ratio was 0.12 (IQR0.10-0.15). Cortical atrophy (GCA ≥ 1 vs GCA 0) was associated with worse 90-day mRS (acOR = 1.62 [95% CI 1.22-2.16]; DISCUSSION: In this large RCT-derived population, participants with brain atrophy, as visually assessed on acute noncontrast computed tomography imaging, showed less favorable stroke recovery after EVT and worse 90-day functional outcomes compared with participants without brain atrophy. This may support physicians with recovery expectations when planning post-EVT care with patients and their families.

Indexed as

Brain IschemiaEndovascular ProceduresStrokeAgedAged, 80 and overAtrophyBrainHumansMaleMiddle AgedRetrospective StudiesThrombectomyTreatment Outcome

Identifiers

PMID37591777
PMCPMC10585701
OpenAlexW4385919769

What OpenQuestion holds

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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.