Evidence map›Paper›PMID 38836272›Full record

ArticleJournal of stroke2024

How Do Quantitative Tissue Imaging Outcomes in Acute Ischemic Stroke Relate to Clinical Outcomes?

Johanna M Ospel, Leon Rinkel, Aravind Ganesh, Andrew Demchuk, Manraj Heran, Eric Sauvageau, Manish Joshi, Diogo Haussen, Mahesh Jayaraman, Shelagh Coutts and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. 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

21 authors.

Johanna M OspelDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
Leon RinkelDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
Aravind GaneshDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Andrew DemchukDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
Manraj HeranDepartment of Radiology, University of British Columbia, Vancouver, BC, Canada.
Eric SauvageauLyerly Neurosurgery, Baptist Hospital, Jacksonville, FL, USA.
Manish JoshiDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
Diogo HaussenEmory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA.
Mahesh JayaramanWarren Alpert School of Medicine, Brown University, Providence, RI, USA.
Shelagh CouttsDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Amy YuUniversity of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Volker PuetzUniversity Hospital Carl Gustav Carus at the Technische Universität Dresden, Department of Neurology and Dresden Neurovascular Center, Dresden, Germany.
Dana IancuCentre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Oh Young BangDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Jason TarpleyProvidence Little Company of Mary Medical Center, Providence Saint John's Health Center and The Pacific Neuroscience Institute, Torrance, CA, USA.
Staffan HolminDepartment of Clinical Neuroscience, Karolinska Institutet and Departments of Neuroradiology and Neurology, Karolinska University Hospital, Stockholm, Sweden.
Michael KellyRoyal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada.
Michael TymianskiNoNO Inc., Toronto, ON, Canada.
Michael HillDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
Mayank GoyalDepartment of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
ESCAPE-NA1 Investigators

Funding

Alberta InnovatesCIHRNoNO Inc.
6 · The paper itself

Abstract

background and purposeInfarct volume and other imaging markers are increasingly used as surrogate measures for clinical outcome in acute ischemic stroke research, but how improvements in these imaging surrogates translate into better clinical outcomes is currently unclear. We investigated how changes in infarct volume at 24 hours alter the probability of achieving good clinical outcome (modified Rankin Scale [mRS] 0-2).

methodsData are from endovascular thrombectomy patients from the randomized controlled ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial. Infarct volume at 24 hours was manually segmented on non-contrast computed tomography or diffusion-weighted magnetic resonance imaging. Probabilities of achieving good outcome based on infarct volume were obtained from a multivariable logistic regression model. The probability of good outcome was plotted against infarct volume using linear spline regression.

resultsA total of 1,099 patients were included in the analysis (median final infarct volume 24.9 mL [interquartile range: 6.6-92.2]). The relationship between total infarct volume and good outcome probability was nearly linear for infarct volumes between 0 mL and 250 mL. In this range, a 10% increase in the probability of achieving mRS 0-2 required a decrease in infarct volume of approximately 34.0 mL (95% confidence interval: -32.5 to -35.6). At infarct volumes above 250 mL, the probability of achieving mRS 0-2 probability was near zero. The relationships of tissue-specific infarct volumes and parenchymal hemorrhage volume generally showed similar patterns, although variability was high.

conclusionThere seems to be a near-linear association between total infarct volume and probability of achieving good outcome for infarcts up to 250 mL, whereas patients with infarct volumes greater than 250 mL are highly unlikely to have a favorable outcome.

Indexed as

Acute strokeInfarct volumeIschemiaThrombectomy

Identifiers

PMID38836272
PMCPMC11164591

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.