Safety and efficacy of endovascular treatment for patients with a mismatch between non-contrast CT and CBV ASPECTS
Bibliographic record
Abstract
Objective In acute ischemic stroke (AIS), the low density range of non-contrast computed tomography (NCCT) is larger than that of cerebral blood volume (CBV) from time to time, and there is a mismatch between them. The study aimed to study the safety and efficacy of endovascular treatment (ET) in the patients with NCCT-CBV Alberta stroke program early CT score (ASPECTS) < 0 (N-C < 0) and explore the role of related predictors in the prognosis. Methods Clinical data of 290 consecutive patients with anterior circulation intracranial vascular occlusion undergoing ET in our hospital from January 2015 to August 2018 were collected to conduct a retrospective study. According to N-C score, they were divided into N-C < 0 and N-C>0 groups. The safety outcome were assessed by 90 days of death, severe intracranial hemorrhage, symptomatic intracranial hemorrhage (sICH), and the efficacy outcome included National Institutes of Health Stroke Scale (NIHSS) score at day 7 or discharge, and good functional outcome (mRS≤2) at day 90. The differences between the N-C < 0 and ≥0 groups were compared, and the related predictors for good prognosis were explored by multivariate logistic regression analysis. Results A total of 144 patients were eligible for our inclusion criteria, of 25 in the N-C < 0 group and 119 in the N-C≥0 group. The N-C < 0 group had lower NCCT ASPECTS than the other group (6.96±1.77 vs 8.73±1.25, P < 0.001). Meanwhile, significant differences were seen in the classification of vessels (P=0.036) and the time from puncture to recanalization (P=0.017) between the 2 groups. There were no significant differences in safety and efficacy between the 2 groups. Multivariate regression model showed that CBV ASPECTS (P=0.010, OR=1.460, 95%CI=1.095~1.945) was an independent predictor for good prognosis. Conclusion The patients with N-C < 0 are benefited from ET without increasing risk of intracranial hemorrhage. The low-density lesions of NCCT should not be used as a criterion for excluding or judging the poor functional outcome of ET, but should be further evaluated according to CBV images.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 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".