Evidence map›Paper›PMID 41474412›Full record

ArticleCNS neuroscience & therapeutics2026

A Novel and Simple Score to Predict Embolic or Atherosclerotic Middle Cerebral Artery Occlusion Before Mechanical Thrombectomy: AHOC Score.

Hudie Zhang, Yingwen Su, Zubing Xu, Yunqing Chen, Rongwei Yang, Weiming Gan, Zhaojun Huang, Laisheng Cai, Chenying Zeng, Qin Huang and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CNS neuroscience & therapeutics, 2026. 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

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

18 authors.

Hudie ZhangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Yingwen SuDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Zubing XuDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Yunqing ChenDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Rongwei YangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Weiming GanDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Zhaojun HuangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Laisheng CaiDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Chenying ZengDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Qin HuangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jinchong ZhangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Keji ZouDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jingwei HuangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Pu FangDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Xiaobing LiDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.ORCID 0000-0001-7950-2481
Yuhua FanDepartment of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.ORCID 0000-0002-1172-1490
Daojun HongDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jing LinDepartment of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.ORCID 0009-0005-6239-1339

Funding

the Educational Science Foundation of Jiangxi Province GJJ2200136the National Natural Science Foundation of China 82460247the Natural Science Foundation of Jiangxi Province 20212BAB216023
6 · The paper itself

Abstract

objectiveThe mechanical thrombectomy (MT) strategy obviously differs for acute middle cerebral artery occlusion (MCAO) stroke caused by embolism or atherosclerosis. Our study aimed to develop and validate a simple and universally applicable score for predicting etiology [embolism or intracranial arteriosclerosis (ICAS)] before MT in patients with acute MCAO stroke.

methodsBetween November 2019 and September 2022, we retrospectively enrolled eligible patients in our hospital as the training cohort. Additionally, consecutive patients between July 2023 and April 2024 were recruited as the validation cohort. Multivariate logistic regression analysis was used to identify the independent factors associated with etiology in the training group. Each factor was then point assigned based on β-coefficient, and a risk scoring system was developed. The scoring system was validated through the validation cohort. The C-statistic, Brier score, and Hosmer-Lemeshow test were used to assess model discrimination and calibration.

resultsThe training group and validation group finally included 277 patients (154 embolism-MCAO and 123 ICAS-MCAO) and 101 patients (59 embolism-MCAO and 42 ICAS-MCAO), respectively. A scoring system (AHOC score) covering four variables (atrial fibrillation, hyperdense middle cerebral artery sign, stenosis/occlusion in other arteries, and collateral status) was derived to help identify embolism-MCAO or ICAS-MCAO. The AHOC score showed good discrimination and calibration in the training cohort (C-statistic, 0.932 [0.902-0.963]; Brier score, 0.092 [0.070-0.115]; p value of the Hosmer-Lemeshow test, 0.604) and in the validation cohort (C-statistic, 0.933 [0.888-0.978]; Brier score, 0.102 [0.067-0.140]; p value of the Hosmer-Lemeshow test, 0.846). According to the AHOC score, patients with a score of 4-8 were identified as high-risk for the embolism-MCAO category. Conversely, a patient with a score of 0-3 was considered high-risk for the ICAS-MCAO category.

conclusionsOur scoring system (AHOC score), consisting of atrial fibrillation, hyperdense middle cerebral artery sign, stenosis/occlusion in other arteries and collateral status, is a valid and applicable model for predicting the etiology in patients with acute MCAO before MT.

Indexed as

Infarction, Middle Cerebral ArteryIntracranial ArteriosclerosisIntracranial EmbolismThrombectomyAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective Studiesembolismintracranial arteriosclerosismechanical thrombectomymiddle cerebral occlusionscoring system

Identifiers

PMID41474412
PMCPMC12755222

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.