Abstract TMP102: Predicting Recovery and Outcome After Pediatric Stroke
Bibliographic record
Abstract
We aimed to characterize the timing of recovery and predictors of outcome following pediatric stroke, with the hypothesis that the recovery pattern after stroke is influenced by age. While the immature brain is often presumed to have an increased capacity for neuroplasticity, there is little direct data examining how recovery differs in children of different ages. We reviewed data for children with arterial ischemic stroke (AIS) who were enrolled in the International Pediatric Stroke Study, a prospective registry of children with stroke. Inclusion criteria included a diagnosis of AIS and the availability of outcome at two years after the index stroke event. A subset of these patients who had multiple assessments over time were used to study longitudinal patterns of recovery. We investigated demographic, clinical, and radiologic associations with both early outcome at discharge and long term outcome at two years using multinomial logistic regression. Categorical outcomes at each timepoint were defined by Pediatric Stroke Outcome Measure (PSOM). We studied longitudinal recovery using time-to-event (survival) analysis. 614 out of 4,294 patients met our inclusion criteria. 202 patients had perinatal AIS while 412 had childhood AIS. Perinatal AIS was associated with significant worsening between discharge and two years, as neurologic impairment became more apparent, but with better outcomes at both timepoints compared with childhood AIS (moderate/severe: 14% vs 49% at discharge, 47% vs 54% at 2 years). Predictors of severe deficits in univariate analyses included age at stroke (perinatal vs. childhood), hemiparesis or decreased consciousness at presentation, anterior circulation, and large vessel involvement. In longitudinal analysis, improvement in PSOM occurred for a longer time after stroke onset in younger children compared to older children. Although age has a strong influence on recovery after pediatric stroke, all children had the capacity to demonstrate recovery over extended periods of time. Understanding the timing and predictors of recovery will allow us to better target therapies to the appropriate windows of opportunity, thereby improving outcomes after pediatric stroke.
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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 | 0.001 | 0.005 |
| 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 | 0.001 |
| 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".