Analysis of influence factors for unfavorable prognosis in acute basilar artery occlusion treated with endovascular thrombectomy
Bibliographic record
Abstract
Objective To screen the risk factors related to unfavorable prognosis and evaluate the predictive effect of four imaging scoring systems on the unfavorable prognosis in the patients with acute basilar artery occlusion (BAO) after endovascular thrombectomy. Methods From March 2012 to August 2018, a total of 57 patients with acute BAO were treated with endovascular thrombectomy, preoperative DWI Posterior Circulation Alberta Stroke Program Early CT Score (pc ⁃ ASPECTS), DWI Brain Stem Score (BSS), Posterior Circulation CTA (pc ⁃ CTA) and Basilar Artery CTA (BATMAN) were used. Thrombolysis in Cerebral Infarction (TICI) was used to evaluate the incidence of vascular recanalization. The incidence of symptomatic intracranial hemorrhage (sICH) was recorded within 36 h. The prognosis was evaluated by modified Rankin Scale (mRS) at 3 months. Univariate and multivariate backward Logistic regression analysis were used to screen the risk factors related to the unfavoriable prognosis in the patients with acute BAO after endovascular thrombectomy. Receiver operating characteristic curve (ROC) was used to calculate the area under the curve (AUC), and evaluate the predictive value of DWI pc ⁃ ASPECTS, DWI BSS, pc ⁃ CTA and BATMAN scores for prognosis. Results In 57 patients, 53 patients (92.98% ) had successful recanalization, 2 (3.51%) had partial recanalization, 2 (3.51%) had no recanalization, 3 (5.26%) had sICH, 22 (38.60%) had good prognosis, 35 (61.40%) had poor prognosis, and 14 (24.56%) died. After univariate and multivariate backward Logistic regression analysis, higher NIHSS score on admission ( OR = 0.879, 95% CI: 0.783-0.986; P = 0.028), higher DWI BSS score ( OR = 0.348, 95% CI: 0.177-0.683; P = 0.002) and lower BATMAN score ( OR = 1.549, 95% CI: 1.019-2.353; P = 0.040) were risk factors for unfavorable prognosis of patients with acute BAO after endovascular thrombectomy. ROC analysis of the four radiographic scoring systems showed that the AUC of DWI pc ⁃ ASPECTS, DWI BSS, pc ⁃ CTA and BATMAN score were 0.787 (95% CI: 0.658-0.884, P = 0.000), 0.861 (95% CI: 0.744-0.938, P = 0.000), 0.634 (95% CI: 0.496-0.757, P = 0.091) and 0.698 (95% CI: 0.562-0.813, P = 0.012), respectively. Conclusions Higher NIHSS score on admission, higher DWI BSS score and lower BATMAN score are risk factors for unfavorable prognosis of acute BAO treated with endovascular thrombectomy. DOI：10.3969/j.issn.1672⁃6731.2020.05.006
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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 | 0.000 |
| 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".