Stroke Is Different in Systemic Lupus Erythematosus: Implications for Survival and Functionality
Bibliographic record
Abstract
Undoubtedly, individuals with systemic lupus erythematosus (SLE) are at higher risk for developing cerebrovascular disease than counterparts from the general population without SLE. In a metaanalysis of studies from around the world, the likelihood of individuals with SLE developing both ischemic and hemorrhagic stroke (intracerebral and/or subarachnoid hemorrhage) was more than 2 times that of the general population1. Risks for stroke appear to be highest soon after SLE diagnosis, and concomitant antiphospholipid syndrome (APS) in these patients does not markedly exacerbate risks for ischemic stroke2. As stroke commonly occurs at a younger age in SLE than in the general population2,3,4, shorter survival and impaired functionality after stroke will impose a greater burden on a patient with SLE than a patient from the general population. Little is known, however, on poststroke outcomes in SLE from prospective studies. One of the few available studies is an investigation from Sweden5 in which registers, including a stroke register with universal coverage, were used to identify strokes and their outcomes in individuals with and without SLE. In this study, patients with SLE had a 1.4-fold higher risk for death (from any cause) after the onset of ischemic stroke compared to individuals without SLE5. Relative risks for 1-year mortality were even higher for hemorrhagic stroke (2.3-fold higher)5. In addition, SLE was associated with a 73% higher risk of functional dependence in daily activities 3 months after ischemic stroke onset5. Results from one study may not be generalized to all settings and populations because stroke characteristics and care for these patients may differ among populations. Studies from other SLE populations were therefore warranted. In the article published in this issue of The Journal , Tsoi and colleagues6 aimed to … Address correspondence to Dr. M. Rossides, Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Division, Karolinska University Hospital T2, 171 76 Stockholm, Sweden. Email: marios.rossides{at}ki.se.
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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 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 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".