Predictors of fatal outcome in patients with acute ischemic stroke
Bibliographic record
Abstract
Background. Acute stroke is one of the main causes of long-term disability and mortality. Hemorrhagic transformation (HT) is a severe complication of acute ischemic stroke (AIS), which may be fatal. Purpose – to analyze the risk factors of AIS with fatal outcome. Materials and Methods. 81 patients with AIS were examined at the neurological department of St. Panteleimon Hospital. The subjects were divided into 2 groups: group 1 – 57 patients with AIS; group 2 – 24 individuals with AIS who died. All individuals underwent examination, Glasgow Coma Scale, NIHSS (National Institutes of Health Stroke Scale), complete and biochemical blood tests, coagulogram, ECG and EchoCG. Head CT and ASPECTS (Alberta Stroke Program Early CT score) assessment were performed to determine the localization and extent of acute ischemic stroke. Results. All individuals were admitted with impaired consciousness and focal cerebral symptoms (hemiplegia, hemihypesthesia, aphasia, dysarthria, hemianopsia) depending on the area of the lesion. Heart rate (HR) was significantly higher in patients in group 2 (p = 0.006). Patients in group 2 had a more severe condition, reflected in a lower Glasgow Coma Scale score (p = 0.017). Hemorrhagic transformation was significantly more frequent in patients of group 2 (group 1 = 17.5%; group 2 – 54.2%; p = 0.008), which was observed in more than half of patients. Contrast-enhanced CT scans visualized hypodense areas without clear contours, heterogeneous due to hyperdense linear inclusions. CT angiography showed thromboses mainly in the basin of the left (group 1 – 36.8%; group 2 – 37.5%; p = 0.955) and right middle cerebral artery (group 1 – 36.8%; group 2 – 41.7%; p = 0.683). Evaluating on the ASPECTS scale, group 1 received 5.7 ± 3.4 points, while in group 2 – 6.6 ± 2.4 (p = 0.537). Conclusions. Hemorrhagic transformation is an independent risk factor that reduces the chances of survival in patients with AIS (group 1 = 17.5%; group 2 – 54.2%; p = 0.008). Significantly higher levels of glucose (p = 0.045), AST (p = 0.040), and sodium (p = 0.035) and higher HR (p = 0.006) were diagnosed in persons who died. The increase in these indicators in patients with AIS can be considered a predictor of adverse disease outcome.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".