Intravenous Thrombolysis Increases the Rate of Dramatic Recovery in Patients with Acute Stroke with an Unknown Onset Time and Negative FLAIR MRI
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: The safety and feasibility of intravenous thrombolysis using recombinant tissue plasminogen activator (IV-tPA) were retrospectively compared between patients with unknown onset time and no ischemia on fluid-attenuated inversion recovery (negative FLAIR) and patients receiving standard therapy. METHODS: Acute stroke patients with unknown onset times were treated using IV-tPA if they had: negative FLAIR; internal carotid artery and/or middle cerebral artery occlusion; and a diffusion-weighted imaging (DWI)-Alberta Stroke Programme Early CT Score ≥5. All patients had abnormal DWI scans indicating an acute stroke. IV-tPA therapy was performed within 3-4.5 h of first found abnormal time (FAT). Patients who were admitted within 3-4.5 h of FAT and did not receive IV-tPA therapy despite the same imaging findings were extracted from our registry as controls. RESULTS: There were 24 patients in the IV-tPA group and 28 in the control group. None of the IV-tPA group and 1 (4%) of the control group patients experienced symptomatic intracerebral hemorrhage (P = 1.000). The rate of dramatic recovery at day 7 (≥10-point reduction in the total National Institutes of Health Stroke Scale [NIHSS] score or NIHSS score of 0-1) was 46% in the IV-tPA group and 18% in the control group (P = .038). Multivariate regression analysis revealed that IV-tPA was an independent predictor of dramatic recovery at day 7 (odds ratio 13.74; 95% confidence interval, 1.95-96.92; P = .009). CONCLUSIONS: IV-tPA may safely increase the rate of dramatic recovery in acute stroke patients with unknown onset times and negative FLAIR.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".