Evidence map›Paper›PMID 40188256›Full record

Observational studyScientific reports2025

Later midline shift is associated with better post-hospitalization discharge status after large middle cerebral artery stroke.

Jonathan J Song, Rebecca A Stafford, Jack E Pohlmann, Ivy So Yeon Kim, Maanyatha Cheekati, Sydney Dennison, Benjamin Brush, Stefanos Chatzidakis, Qiuxi Huang, Stelios M Smirnakis and 7 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Jonathan J SongDepartment of Neurology, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Rebecca A StaffordDepartment of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.
Jack E PohlmannDepartment of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.
Ivy So Yeon KimDepartment of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.
Maanyatha CheekatiDepartment of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
Sydney DennisonDepartment of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
Benjamin BrushDepartment of Neurology, NYU Langone Medical Center, 550 1st Ave, New York, NY, 10016, USA.
Stefanos ChatzidakisDepartment of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Qiuxi HuangDepartment of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
Stelios M SmirnakisDepartment of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Emily J GilmoreDepartment of Neurology, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
Shariq MohammedDepartment of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
Mohamad AbdalkaderDepartment of Radiology, Boston Medical Center, 1 Boston Medical Center Pl, Boston, MA, 02118, USA.
Emelia J BenjaminDepartment of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA.
Josée DupuisDepartment of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
David M GreerDepartment of Neurology, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Charlene J OngDepartment of Neurology, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA. cjong@bu.edu.

Funding

Project-005UL1TR001430 · NCATS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BAIR-MERRITT, MEGAN H, CENTER, DAVID M. · 2015 to 2024
$52.3M
IDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVALR01HL092577 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2009 to 2025
$20.6M
Multimodal Network Connectivity Architecture (MOCA) of the Brain and its Role in the Recovery of Consciousness in Comatose Cardiac Arrest PatientsR01NS102574 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, DAVID MATTHEW, WU, ONA · 2018 to 2022
$3.4M
Addressing an Inherent Bias in Neuroprognostication: A Collaboration Between the US and Brazil to Reduce the Impact of Self-Fulfilling Prophecy in Cardiac ARrEst (SPARE)R01NS128342 · NINDS · BOSTON MEDICAL CENTER · PI David Matthew Greer, Gisele Sampaio Silva · 2024 to 2026
$1.9M
Dynamic Risk Prediction of Life-Threatening Mass Effect After Ischemic StrokeK23NS116033 · NINDS · BOSTON MEDICAL CENTER · PI ONG, CHARLENE J · 2021 to 2025
$1.0M
MEDICAL STUDENT SUMMER RESEARCH PROGRAM IN HEART, LUNG AND BLOOD DISEASES (RPHLB)T35HL139444 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FINE, ALAN FINE, SARFATY, SUZANNE · 2019 to 2023
$479k
American Heart Association 23CDA1041762American Heart Association AFNATIONAL HEART, LUNG, & BLOOD INSTITUTE T35HL139444NCATS NIH HHS UL1 TR001430NHLBI NIH HHS R01 HL092577NHLBI NIH HHS T35 HL139444NIH HHS HL092577NIH HHS NS128342NIH/NINDS K23NS116033NIH/NINDS NS102574NINDS NIH HHS K23 NS116033NINDS NIH HHS R01 NS102574NINDS NIH HHS R01 NS128342
6 · The paper itself

Abstract

Space occupying cerebral edema is a feared complication after large ischemic stroke, occurring in up to 30% of patients with middle cerebral artery (MCA) occlusion and peaking 2-4 days after injury. Little is known about the factors and outcomes associated with peak edema timing, especially after 96 h. We aimed to characterize differences and compare discharge status between patients who experienced maximum midline shift (MLS) or decompressive hemicraniectomy (DHC) in the acute (< 48 h), average (48-96 h), and subacute (> 96 h) groups. We performed a two-center, retrospective study of patients with ≥ 1/2 MCA territory infarct and MLS. We constructed a multivariable model to test the association of subacute peak edema and favorable discharge status, adjusting for various confounders. Of 321 eligible patients, 32%, 36%, and 32% experienced acute, average, and subacute peak edema. Subacute peak edema was significantly associated with higher odds of favorable discharge than acute peak edema (aOR, 2.05; 95% CI, 1.03-4.11). Subacute peak edema after large MCA stroke is associated with better discharge status compared to acute peak edema courses. Understanding how the timing of cerebral edema affects risk of unfavorable discharge has important implications for treatment decisions and prognostication.

Indexed as

Brain EdemaInfarction, Middle Cerebral ArteryPatient DischargeAgedDecompressive CraniectomyFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsCerebral edemaMass effectMiddle cerebral arteryMidline shiftSwellingTiming

Identifiers

PMID40188256
PMCPMC11972405

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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.