Clinical Predictors of Acute Ischemia in Patients with Low-Risk Neurological Deficits

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27661989%3A_____%2F24%3A10003362" target="_blank" >RIV/27661989:_____/24:10003362 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00159816:_____/25:00081779

Výsledek na webu

<a href="https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/clinical-predictors-of-acute-ischemia-in-patients-with-lowrisk-neurological-deficits/D11EBAE1927DABA68C97DB8A8661AD83" target="_blank" >https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/clinical-predictors-of-acute-ischemia-in-patients-with-lowrisk-neurological-deficits/D11EBAE1927DABA68C97DB8A8661AD83</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1017/cjn.2024.274" target="_blank" >10.1017/cjn.2024.274</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Clinical Predictors of Acute Ischemia in Patients with Low-Risk Neurological Deficits

Popis výsledku v původním jazyce

Background: Diagnosis of acute ischemia typically relies on evidence of ischemic lesions on magnetic resonance imaging (MRI), a limited diagnostic resource. We aimed to determine associations of clinical variables and acute infarcts on MRI in patients with suspected low-risk transient ischemic attack (TIA) and minor stroke and to assess their predictive ability.Methods: We conducted a post-hoc analysis of the Diagnosis of Uncertain-Origin Benign Transient Neurological Symptoms (DOUBT) study, a prospective, multicenter cohort study investigating the frequency of acute infarcts in patients with low-risk neurological symptoms. Primary outcome parameter was defined as diffusion-weighted imaging (DWI)-positive lesions on MRI. Logistic regression analysis was performed to evaluate associations of clinical characteristics with MRI-DWI-positivity. Model performance was evaluated by Harrel&apos;s c-statistic.Results: In 1028 patients, age (Odds Ratio (OR) 1.03, 95% Confidence Interval (CI) 1.01-1.05), motor (OR 2.18, 95%CI 1.27-3.65) or speech symptoms (OR 2.53, 95%CI 1.28-4.80), and no previous identical event (OR 1.75, 95%CI 1.07-2.99) were positively associated with MRI-DWI-positivity. Female sex (OR 0.47, 95%CI 0.32-0.68), dizziness and gait instability (OR 0.34, 95%CI 0.14-0.69), normal exam (OR 0.55, 95%CI 0.35-0.85) and resolved symptoms (OR 0.49, 95%CI 0.30-0.78) were negatively associated. Symptom duration and any additional symptoms/symptom combinations were not associated. Predictive ability of the model was moderate (c-statistic 0.72, 95%CI 0.69-0.77).Conclusion: Detailed clinical information is helpful in assessing the risk of ischemia in patients with low-risk neurological events, but a predictive model had only moderate discriminative ability. Patients with clinically suspected low-risk TIA or minor stroke require MRI to confirm the diagnosis of cerebral ischemia.

Název v anglickém jazyce

Clinical Predictors of Acute Ischemia in Patients with Low-Risk Neurological Deficits

Popis výsledku anglicky

Background: Diagnosis of acute ischemia typically relies on evidence of ischemic lesions on magnetic resonance imaging (MRI), a limited diagnostic resource. We aimed to determine associations of clinical variables and acute infarcts on MRI in patients with suspected low-risk transient ischemic attack (TIA) and minor stroke and to assess their predictive ability.Methods: We conducted a post-hoc analysis of the Diagnosis of Uncertain-Origin Benign Transient Neurological Symptoms (DOUBT) study, a prospective, multicenter cohort study investigating the frequency of acute infarcts in patients with low-risk neurological symptoms. Primary outcome parameter was defined as diffusion-weighted imaging (DWI)-positive lesions on MRI. Logistic regression analysis was performed to evaluate associations of clinical characteristics with MRI-DWI-positivity. Model performance was evaluated by Harrel&apos;s c-statistic.Results: In 1028 patients, age (Odds Ratio (OR) 1.03, 95% Confidence Interval (CI) 1.01-1.05), motor (OR 2.18, 95%CI 1.27-3.65) or speech symptoms (OR 2.53, 95%CI 1.28-4.80), and no previous identical event (OR 1.75, 95%CI 1.07-2.99) were positively associated with MRI-DWI-positivity. Female sex (OR 0.47, 95%CI 0.32-0.68), dizziness and gait instability (OR 0.34, 95%CI 0.14-0.69), normal exam (OR 0.55, 95%CI 0.35-0.85) and resolved symptoms (OR 0.49, 95%CI 0.30-0.78) were negatively associated. Symptom duration and any additional symptoms/symptom combinations were not associated. Predictive ability of the model was moderate (c-statistic 0.72, 95%CI 0.69-0.77).Conclusion: Detailed clinical information is helpful in assessing the risk of ischemia in patients with low-risk neurological events, but a predictive model had only moderate discriminative ability. Patients with clinically suspected low-risk TIA or minor stroke require MRI to confirm the diagnosis of cerebral ischemia.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30224 - Radiology, nuclear medicine and medical imaging

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Canadian Journal of Neurological Sciences

ISSN

0317-1671

e-ISSN

2057-0155

Svazek periodika

52

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

6

Strana od-do

241-246

Kód UT WoS článku

001302725800001

EID výsledku v databázi Scopus

2-s2.0-85195302420