目的 构建和评价轻型缺血性卒中(minor ischemic stroke,MIS)患者发病后90d时转归不良的列线图预测模型.方法 回顾性分析2022年1月至2023年6月期间合肥市第二人民医院收治的MIS患者.在发病后90d时应用改良Rankin量表进行转归评价,＜2分定义为转归良好,≥2分定义为转归不良.采用多变量logistic回归分析确定患者转归不良的独立危险因素,并据此构建列线图预测模型.结果 共纳入177例MIS患者,其中61例(34.46％)转归不良.多变量logistic回归分析显示,高血压[优势比(odds ratio,OR)3.484,95％置信区间(confidence interval,CI)1.378～8.810;P=0.008]、糖尿病(OR 2.936,95％CI 1.301～6.625;P=0.009)、入院时美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(OR 2.936,95％CI 1.027～1.709;P=0.031)和入院时收缩压(OR 1.083,95％CI 1.053～1.115;P＜0.001)是转归不良的独立危险因素.建立的列线图预测模型c统计量为0.828,曲线下面积为0.841(95％CI0.778～0.891),校准曲线与理想曲线拟合良好.临床决策曲线显示,该模型具有较强的临床适用性.结论 高血压、糖尿病、入院时NIHSS评分和收缩压是MIS患者转归不良的独立危险因素.基于上述因素构建的列线图对MIS患者的转归不良具有较高的分辨力和临床价值.
A nomogram prediction model for poor outcome in patients with minor ischemic stroke
Objective To develop and evaluate a nomogram prediction model for poor outcome in patients with minor acute ischemic stroke(MIS)at 90 days after onset.Methods Patients with MIS admitted to the Second People's Hospital of Hefei from January 2022 to June 2023 were retrospectively enrolled.At 90 days after onset,the modified Rankin Scale was used for outcome evaluation.＜2 points were defined as good outcome and ≥2 points were defined as poor outcome.Multivariate logistic regression analysis was used to identify independent risk factors for poor outcome,and a nomogram prediction model was developed based on these factors.Results A total of 177 patients with MIS were included,of which 61(34.46％)had poor outcome.Multivariate logistic regression analysis showed that hypertension(odds ratio[OR]3.484,95％confidence interval[CI]1.378-8.810;P=0.008),diabetes(OR 2.936,95％CI 1.301-6.625;P=0.009),National Institutes of Health Stroke Scale(NIHSS)score at admission(OR 2.936,95％CI 1.027-1.709;P=0.031)and systolic blood pressure at admission(OR 1.083,95％CI 1.053-1.115;P＜0.001)were the independent risk factors for poor outcome.The established nomogram prediction model had a C-index of 0.828 and the area under the curve was 0.841(95％CI 0.778-0.891).The calibration curve fitted well with the ideal curve.The clinical decision curve showed that the model had stronger clinical applicability.Conclusions Hypertension,diabetes,NIHSS score and systolic blood pressure at admission are independent risk factors for poor outcome of patients with MIS.The nomogram based on the above factors has higher discriminative power and clinical value for predicting poor outcome in patients with MIS.
Ischemic strokeSeverity of illness indexTreatment outcomeRisk factorsNomograms
万方数据
维普
