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Attempts to clarify the identity of obscure New Zealand spider taxa have lead to the conclusion that six species are best treated as nomina dubia [Philodromus rubrofrontus Urquhart 1891 (Philodromidae); Dictyna urquhartii Roewer 1951, (Dictynidae); Linyphia albiapiata Urquhart 1891, Linyphia cruenta Urquhart 1891, Linyphia multicolor Urquhart 1891, Linyphia pellos Urquhart 1891 (Linyphiidae)]. Four species currently listed in Araneus Clerck 1757 (Araneidae) are re-affirmed as synonyms [Araneus lineaacutus (Urquhart 1887) = Zealaranea crassa (Walckenaer 1842), Araneus powelli (Urquhart 1894) = Novaranea laevigata (Urquhart 1891), Araneus sublutius (Urquhart 1892b) = Zealaranea trinotata (Urquhart 1890), Araneus ventricosellus (Roewer 1942) = Eriophora heroine (L. Koch 1871)]. An old record of Araneus brisbanae (L. Koch 1867b) (Araneidae) from New Zealand is a misidentification of Eriophora decorosa Urquhart 1894. The family Philodromidae, the genera Dictyna Sundevall 1833 (Dictynidae) and Linyphia Latreille 1804 (Linyphiidae), as well as Tharpyna munda L. Koch 1875 (Thomisidae) and Araneus brisbanae (Araneidae) are absent from New Zealand.
Background: Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography.
Methods: In a systematic review of OVID MEDLINE—with additional hand-searching of relevant studies' bibliographies— from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage. We sought individual patient-level data from corresponding authors for patients aged 18 years or older with data available from brain imaging initially done 0·5–24 h and repeated fewer than 6 days after symptom onset, who had baseline intracerebral haemorrhage volume of less than 150 mL, and did not undergo acute treatment that might reduce intracerebral haemorrhage volume. We estimated the absolute risk and predictors of the primary outcome of intracerebral haemorrhage growth (defined as >6 mL increase in intracerebral haemorrhage volume on repeat imaging) using multivariable logistic regression models in development and validation cohorts in four subgroups of patients, using a hierarchical approach: patients not taking anticoagulant therapy at intracerebral haemorrhage onset (who constituted the largest subgroup), patients taking anticoagulant therapy at intracerebral haemorrhage onset, patients from cohorts that included at least some patients taking anticoagulant therapy at intracerebral haemorrhage onset, and patients for whom both information about anticoagulant therapy at intracerebral haemorrhage onset and spot sign on acute CT angiography were known.
Findings: Of 4191 studies identified, 77 were eligible for inclusion. Overall, 36 (47%) cohorts provided data on 5435 eligible patients. 5076 of these patients were not taking anticoagulant therapy at symptom onset (median age 67 years, IQR 56–76), of whom 1009 (20%) had intracerebral haemorrhage growth. Multivariable models of patients with data on antiplatelet therapy use, data on anticoagulant therapy use, and assessment of CT angiography spot sign at symptom onset showed that time from symptom onset to baseline imaging (odds ratio 0·50, 95% CI 0·36–0·70; p<0·0001), intracerebral haemorrhage volume on baseline imaging (7·18, 4·46–11·60; p<0·0001), antiplatelet use (1·68, 1·06–2·66; p=0·026), and anticoagulant use (3·48, 1·96–6·16; p<0·0001) were independent predictors of intracerebral haemorrhage growth (C-index 0·78, 95% CI 0·75–0·82). Addition of CT angiography spot sign (odds ratio 4·46, 95% CI 2·95–6·75; p<0·0001) to the model increased the C-index by 0·05 (95% CI 0·03–0·07).
Interpretation: In this large patient-level meta-analysis, models using four or five predictors had acceptable to good discrimination. These models could inform the location and frequency of observations on patients in clinical practice, explain treatment effects in prior randomised trials, and guide the design of future trials.
Funding: UK Medical Research Council and British Heart Foundation.