ArticleFrontiers in neuroscience2026
Predictors of unfavorable 3-month functional outcome following intravenous thrombolysis with alteplase in anterior circulation acute ischemic stroke: a prospective cohort study.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Intravenous thrombolysis with alteplase remains the standard reperfusion strategy for acute ischemic stroke (AIS), yet many patients still experience unfavorable outcomes despite timely treatment, underscoring the need for reliable multimodal prognostic markers. Objective: To identify independent clinical, laboratory, and neuroimaging predictors of unfavorable 3-month functional outcome in anterior circulation AIS treated with alteplase, and to develop, internally validate, and benchmark an integrated multivariable model in accordance with TRIPOD. Methods: This prospective single-center cohort study enrolled 268 consecutive patients with anterior circulation AIS receiving intravenous alteplase within 4.5 h of symptom onset (March 2022-February 2025). Three-month outcome was assessed by the modified Rankin Scale (mRS 0-2 favorable; 3-6 unfavorable) using validated structured instruments administered by blinded raters. Multivariable logistic regression was performed, and the final model was internally validated by 1,000-replicate bootstrap with optimism correction and shrinkage, evaluated by decision curve analysis (DCA), rendered into a nomogram, and benchmarked head-to-head against three previously published reference models using the DeLong test. Results: Of 268 patients, 99 (36.9%) experienced unfavorable outcomes. Seven independent predictors were identified: early neurological deterioration (adjusted OR 3.45, 95% CI 2.01-5.92), large infarction exceeding one-third of the middle cerebral artery territory (OR 2.78, 1.58-4.89), baseline NIHSS (OR 1.14 per point, 1.07-1.22), poor Tan collateral score (OR 2.31, 1.34-3.98), low clot burden score (OR 2.15, 1.28-3.61), elevated D-dimer (OR 2.19, 1.29-3.72), and elevated CRP (OR 1.87, 1.11-3.15). The model achieved an apparent AUC of 0.847 (95% CI 0.801-0.893) and an optimism-corrected AUC of 0.831 (0.785-0.877) on bootstrap validation, with satisfactory calibration (Hosmer-Lemeshow Conclusion: A multimodal panel integrating clinical, inflammatory, coagulation, and neuroimaging parameters independently predicts unfavorable 3-month outcome following intravenous thrombolysis in anterior circulation AIS. The findings are hypothesis-generating pending external validation in independent multicenter cohorts.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.