Evidence map›Paper›PMID 42760870›Full record

ArticleEuropean journal of neurology2026

Association of Time of Day With Functional Outcome in Intracerebral Hemorrhage.

Franziska Lieschke, Eng H Lo, Emiri T Mandeville, Christian Foerch, Elizabeth B Klerman, Jeffrey L Saver, Erik Maronde, Jan Hendrik Schaefer, Ferdinand O Bohmann, Thorsten Steiner and 3 more

Abstract read
In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

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

13 authors.

Franziska LieschkeDepartment of Neurology, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany.ORCID https://orcid.org/0000-0002-5426-9174
Eng H LoDepartment of Radiology, Neuroprotection Research Laboratories, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Emiri T MandevilleDepartment of Radiology, Neuroprotection Research Laboratories, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-7680-0923
Christian FoerchDepartment of Neurology, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany.
Elizabeth B KlermanDepartment of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-7402-3171
Jeffrey L SaverDavid Geffen School of Medicine at UCLA, UCLA Comprehensive Stroke and Vascular Neurology Program, University of California, Los Angeles, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-9141-2251
Erik MarondeDr. Senckenberg Institute for Anatomy II, Experimental Neurobiology, Goethe University Frankfurt, Frankfurt/Main, Germany.ORCID https://orcid.org/0000-0002-5574-6323
Jan Hendrik SchaeferDepartment of Neurology, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany.ORCID https://orcid.org/0000-0002-9465-3533
Ferdinand O BohmannDepartment of Neurology, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany.ORCID https://orcid.org/0000-0001-6439-0667
Thorsten SteinerDepartment of Neurology, Varisano Hospital Frankfurt Höchst, Frankfurt/Main, Germany.ORCID https://orcid.org/0000-0002-5080-8222
Marco SteinDepartment of Neurosurgery, Justus Liebig University Giessen, University Hospital Giessen, Giessen, Germany.
Björn MisselwitzFederal State Consortium of Quality Assurance Hesse, Eschborn, Germany.
Daniel T MarggranderDepartment of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum der Charité, Berlin, Germany.ORCID https://orcid.org/0000-0002-3473-2862

Funding

Goethe-Universität Frankfurt am Main
6 · The paper itself

Abstract

backgroundThe timing of ischemic stroke and intracerebral hemorrhage (ICH) onsets follow distinct daily patterns, but it remains unclear whether these patterns influence ICH outcomes.

methodsConsecutive data were obtained from the prospective stroke inpatient quality assurance registry of Hesse, Germany from 2015 to 2023. Patients with ICH were grouped according to the time of symptom onset: morning (5:00 AM to 10:59 AM), midday (11:00 AM to 4:59 PM), evening (5:00 PM to 10:59 PM), and night (11:00 PM to 4:59 AM). The primary outcome was global disability at discharge, analyzed using ordinal logistic regression. Secondary outcomes included mortality and complications during hospitalization. To account for potential confounding, the analysis incorporated both inverse probability weighting (IPW) and propensity score matching (PSM) based on baseline characteristics.

resultsAfter exclusions, 5665 patients underwent final analysis. Peak ICH incidences occurred around 8:30 AM and 5:00 PM with a minimum at approximately midnight. Patients experiencing ICH during the evening and particularly at night had higher discharge disability, compared to those with symptom onset in the morning or midday. Unadjusted analyses found daily variations in mortality and in-hospital complications that were no longer significant after adjustment by PSM or IPW.

conclusionOur study confirms the daily pattern previously observed in ICH onset, with peak onset during daytime. Functional outcomes were worse in evening and night onset ICH patients. These findings underscore the potential for chronobiologically informed prevention and treatment strategies and the need for further research into time-dependent pathophysiology and care delivery.

Indexed as

Cerebral HemorrhageAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedRegistriesTime Factorsbrain hemorrhagechronobiologycircadian rhythmICH epidemiologyregistries

Identifiers

PMID42760870
PMCPMC13589243

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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.