Abstract 123: Predictors Of Unfavourable Outcome In Medically Treated Symptomatic Intracranial Atherosclerotic Disease.
Bibliographic record
Abstract
Background: Patients with symptomatic intracranial atherosclerotic disease (sICAD) have a 12-14 % annual risk of stroke. The aim of the study was to evaluate the natural history and outcome of patients with sICAD treated medically. Methods: The study population consisted of first ever TIA or stroke patients presenting to this quaternary care centre during the period of January 2008 to March 2011, who on vascular imaging have isolated intracranial atherosclerosis as cause of their symptoms in whom other potential causes have been ruled out and have a follow up of minimum 90days after onset of index event. Unfavourable outcome was defined as presence of TIA, stroke, acute coronary event or vascular death and modified Rankin scale ≥ 3. Results: Fifty three (11.8 %) of the 449 first ever ischemic stroke patients had sICAD. The risk of stroke or TIA in the sICAD territory was 20%, 26.7%, 28.9%, 31.1% in first 7days, 30 days, 90days and 1year respectively. Five (11.1%) patients had cardiovascular events, of these more than two-thirds of these events occurred after 90days of index event and were responsible for 50% mortality in the study. The predictors of unfavourable outcome were presentation as limb weakness (85.7% vs. 58.8%, hazard ratio 1.5; 95%CI, 0.05-0.9; p=0.04), NIHSS at admission ≥8 (50% vs. 5.9%, hazard ratio 8.5; 95%CI, 0.007-0.5; p=0.02), MRI with multiple DWI lesions ( 65.4% vs. 26.7% ;95%CI, 0.04-0.7; p=0.01) and angiography suggestive of diffuse atherosclerosis ( 50% vs. 11.8% ; 95%CI, OR 0.02-0.7 ; p=0.009). On stepwise multiple regression independent variables for unfavourable outcome were NIHSS at admission≥8 (p=0.001, t=3.5), multiple DWI lesion on MRI (p=0.04, t=2.9) and diffuse atherosclerosis on angiography (p=0.006, t=2.9). Conclusion: The patients with sICAD have a very high risk of stroke or TIA in the first 30days even on aggressive medical treatment. Cardiac events are an important cause of mortality and needs close follow-up.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".