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Silent Strike: Stroke in Context of Endocarditis – Brain Imaging as a Catalyst for Diagnosis Cover

Silent Strike: Stroke in Context of Endocarditis – Brain Imaging as a Catalyst for Diagnosis

Open Access
|Feb 2025

Figures & Tables

Table 1

Baseline characteristics of the two groups analyzed with Fisher’s exact test.

CharacteristicOdds ratio (95% confidence interval)(a,b,c,d)
Male gender0.91 (0.35–2.33)(20, 22, 21, 21)
Arterial hypertension0.91 (0.35–2.33)(20, 22, 21, 21)
Type 2 diabetes1 (0.34–2.97)(31, 11, 31, 11)
Dyslipidemia0.41 (0.15–1.08)(20, 22, 29, 13)
Chronic kidney disease1.57 (0.34–8.24)(38, 4, 36, 6)
Chronic heart failure2.11 (0.7–6.7)(34, 8, 28, 14)
History of myocardial infarction0.3 (0.03–1.84)(36, 6, 40, 2)
Concomitant neoplasm2.09 (0.28–24.34)(40, 2, 38, 4)

a = control group, characteristic absent,

b = control group, characteristic present,

c = study group, characteristic absent,

d = study group, characteristic present

Table 2

Baseline laboratory parameters for the two groups;

Laboratory parameterStudy group Median value, (Q1-Q3)Control group Median value, (Q1-Q3)p-value
Serum creatinine level (mg/dL)0.885 (0.71–1.165)0.925 (0.7625–1.11)0.71
Hemoglobin level (g/dL)12.5 (10.03–13.55)14 (12.3–14.875)0.0064
Neutrophil count (*1000/uL)9 (7–12.3)6.78 (4.95–8.61)0.00095
White blood cells count (*1000/uL)11 (8.95–15)9.26 (7.55–12.1775)0.028
Platelet count (*1000/uL)217 (153.65–260.75)249.5 (195.25–291)0.026
Erythrocyte sedimentation rate (mm/h)37.5 (19.25–75.75)20 (9.75–37.75)0.009

[i] Q1 = first quartile, Q3 = third quartile, p-value was calculated by means of Mann-Whitney test. As 6 comparisons were performed, the significance threshold for p-value was lowered to 0.05/6 ≈ 0.01.

[ii] The statistically significant results are highlighted by bold typing.

Table 3

The diagnostic performance of imaging findings on brain CT

Brain CT characteristicSnSpLR+LR−
Hemorrhagic transformation0.190.90520.895
Multiple lesions0.7860.8575.4970.25
Multiple arterial territories0.7380.92910.3940.282
Watershed lesions0.4290.85730.666

[i] Sn = sensitivity, Sp = specificity, LR+ = positive likelihood ratio, LR− = negative likelihood ratio.

Figure 1.

The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of ASPECTS and pc-ASPECTS in predicting endocarditis-related stroke.

Table 4

Clinical outcomes of the two groups (p value = 4×10−13 – as calculated by Fisher’s exact test)

Clinical outcomeStudy group (42 patients)Control group (42 patients)
Improved1242
Worsened140
Deceased160
DOI: https://doi.org/10.2478/rjim-2025-0003 | Journal eISSN: 2501-062X (formerly 1220-4749) | Journal ISSN: 1220-4749
Language: English, Romanian
Page range: 145 - 151
Submitted on: Jul 22, 2024
Published on: Feb 27, 2025
Published by: N.G. Lupu Internal Medicine Foundation
In partnership with: Paradigm Publishing Services

© 2025 Iulia-Cosmina Stoican, Dorin Dragoș, Atena Papagheorghe, Suzana Maria Guberna, Sorin Tuta, Maria Mirabela Manea, published by N.G. Lupu Internal Medicine Foundation
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.