Spinal haemorrhage during anticoagulant regimen for thromboprophylaxis: a unique form of central nervous system haemorrhage
Bibliographic record
Abstract
INTRODUCTION: The management of anticoagulation (AC) therapy in patients with central nervous system (CNS) haemorrhage remains challenging. This study examines the potential factors associated with spinal haematoma among patients who develop CNS haemorrhage while on AC therapy. METHODS: Based on a systematic review using MEDLINE and EMBASE, two reviewers screened publications and extracted data on all CNS-haemorrhage cases. First, all cases were grouped into brain, posterior fossa and spinal haemorrhage. Second, the spinal-haemorrhage group was subdivided into those patients experiencing complete neurological recovery, incomplete recovery, no recovery and death. Finally, axonal survival and inflammatory response after spinal cord injury (SCI) due to trauma and spinal haemorrhage were examined using postmortem spinal cord tissue. RESULTS: Data were extracted from 72 publications including 553 patients. There were significant differences among the CNS groups regarding patient characteristics and management, while their outcomes were comparable. Outcomes among the spinal-haemorrhage subgroups were not associated with patient characteristics and management. Postmortem examination of spinal cord showed that axonal survival and inflammatory response in a spinal-haemorrhage case were similar to a case of traumatic SCI. CONCLUSIONS: The results of this study suggest that the management of patients with spinal haemorrhage considerably differ from individuals with an intracranial haemorrhage during AC. However, survival and neurological recovery appear to be comparable among the CNS groups. The studied factors failed to discriminate the patient subgroups according to survival and neurological recovery. Finally, the neuropathology result reinforces the possibility that the mechanism of SCI may not be relevant for axonal survival and inflammatory response within the spinal cord.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.010 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".