Evidence map›Paper›PMID 41249949›Full record

ArticleBMC infectious diseases2025

A prognostic model for early risk stratification in adult community-acquired suspected CNS infections: multicenter development and external validation.

Fei Tian, Zhaoyang Liu, Weibi Chen, Lili Cui, Dawei Shan, Huimin Zhang, Shuting Chai, Gang Liu, Linlin Fan, Guofeng Li and 12 more

Registry-linked trialAbstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04722328 (Establishment of Prevention and Control System of Central Nervous System Infection), which is not on this map. Not yet cited in PubMed.

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

NCT04722328 unknown statusnot on this map

Establishment of Prevention and Control System of Central Nervous System Infection

TypeobservationalSponsorXuanwu Hospital, BeijingRan2021 to 2025Enrolled715ConditionsCentral Nervous System (CNS) Infection, Encephalitis, MeningitisArmsCSF metagenomic next generation sequencing (mNGS)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

22 authors.

Fei TianDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Zhaoyang LiuDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Weibi ChenDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Lili CuiDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Dawei ShanDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Huimin ZhangDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Shuting ChaiDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Gang LiuDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Linlin FanDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Guofeng LiDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Le YangDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Jiatang ZhangDepartment of Neurology, The First Medical Center of the Chinese PLA General Hospital, Beijing, China.
Jiahua ZhaoDepartment of Neurology, The First Medical Center of the Chinese PLA General Hospital, Beijing, China.
Fengqin HouDepartment of Infectious Diseases, Peking University First Hospital, Beijing, China.
Jianxin DuDepartment of Neurosurgery, You'anmen Hospital, Fengtai District, Beijing, China.
Xinyu HuanDepartment of Neurosurgery, You'anmen Hospital, Fengtai District, Beijing, China.
Ying LvDepartment of Neurology and Psychiatry, Shijitan Hospital, Capital Medical University, Beijing, China.
Xun HuangDepartment of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China.
Rongrong ZhangDepartment of Intensive Care Medicine, The First Affiliated Hospital, University of Science and Technology of China, Hefei, China.
Liyong WuDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
Yingfeng WuDepartment of Vascular Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. xwhvs@163.com.
Yan ZhangDepartment of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. zhangylq@sina.com.

Funding

National Key Research and Development Program of China 2020YFC2005403
6 · The paper itself

Abstract

objectiveCommunity-acquired central nervous system (CNS) infections remain a major cause of morbidity and mortality, particularly in resource-limited settings. Early prognostication is critical but challenged by delays in definitive diagnosis. This study aimed to develop and externally validate a simple prognostic model to support early risk stratification and intervention.

methodsWe conducted a prospective multicenter cohort study in China (NCT04722328), enrolling 1,060 adults with suspected CNS infections. Patients from four hospitals were included in the training group (n = 742) for model development, while patients from three independent hospitals formed the external validation group (n = 318). Independent predictors were identified using least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression. A nomogram was constructed to estimate individualized risk. Model performance was assessed via area under the receiver operating characteristic curve (AUC), concordance index (C-index), calibration plots, decision curve analysis (DCA), and clinical impact curves (CICs).

resultsSix predictors were independently associated with poor outcomes: absence of headache, altered consciousness, respiratory failure, hypoproteinemia, low hemoglobin, and hyperglycemia. The model demonstrated strong discrimination in the training group (AUC 0.811; 95% CI 0.774–0.849) and excellent calibration, with DCA indicating clear clinical benefit. External validation confirmed robust performance (AUC 0.855; 95% CI 0.800–0.910), supporting the model’s generalizability.

conclusionWe established a prognostic model to support early identification of severe cases and guide timely comprehensive management in adult patients with suspected community-acquired CNS infections. CLINICAL REGISTRATION: ClinicalTrials.gov (NCT04722328).

Indexed as

Central Nervous System InfectionsCommunity-Acquired InfectionsAdultAgedChinaFemaleHumansMaleMiddle AgedNomogramsPrognosisProspective StudiesRisk AssessmentRisk FactorsROC CurveCentral nervous system infectionsCommunity-acquired infectionsExternal validationOutcome predictionPrognostic modelRisk stratification

Identifiers

PMID41249949
PMCPMC12625694

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Registered trials

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.