ArticleFrontiers in neurology2023
CNS-LAND score: predicting early neurological deterioration after intravenous thrombolysis based on systemic responses and injury.
Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk prediction models for early neurological deterioration after intravenous thrombolysis in acute ischemic stroke patients: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Prediction models for early neurological deterioration in patients with acute ischemic stroke: a systematic review and critical appraisal.Frontiers in neurologyPooled it
- Evaluation of the CNS-LAND Score for ICU Mortality Prediction in Patients with Spontaneous Intracerebral Hemorrhage.Journal of clinical medicine · 2026Article
- A new nomogram for predicting the risk of ischemic early neurological deterioration after intravenous thrombolysis in acute ischemic stroke: a multicenter retrospective study.BMC neurology · 2026Article
- SPRINFrontiers in neurology · 2026Article
- Neutrophil Mobilization Triggers Microglial Functional Change to Exacerbate Cerebral Ischemia-Reperfusion Injury.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- A clinical-radiomics nomogram to predict early neurological deterioration in patients with stroke undergoing intravenous thrombolysis.Journal of the Chinese Medical Association : JCMA · 2025Article
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Early neurological deterioration (END) is a critical complication in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis (IVT), with a need for reliable prediction tools to guide clinical interventions. Objective: This study aimed to develop and validate a rating scale, utilizing clinical variables and multisystem laboratory evaluation, to predict END after IVT. Design setting and participants: The Clinical Trial of Revascularization Treatment for Acute Ischemic Stroke (TRAIS) cohort enrolled consecutive AIS patients from 14 stroke centers in China (Jan 2018 to Jun 2022). Outcomes: END defined as NIHSS score increase >4 points or death within 24 h of stroke onset. Results: 1,213 patients (751 in the derivation cohort, 462 in the validation cohort) were included. The CNS-LAND score, a 9-point scale comprising seven variables (CK-MB, NIHSS score, systolic blood pressure, LDH, ALT, neutrophil, and D-dimer), demonstrated excellent differentiation of END (derivation cohort C statistic: 0.862; 95% CI: 0.796-0.928) and successful external validation (validation cohort C statistic: 0.851; 95% CI: 0.814-0.882). Risk stratification showed END risks of 2.1% vs. 29.5% (derivation cohort) and 2.6% vs. 31.2% (validation cohort) for scores 0-3 and 4-9, respectively. Conclusion: CNS-LAND score is a reliable predictor of END risk in AIS patients receiving IVT.
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