Objective To investigate the risk factors of cognitive impairment in patients with first ischemic stroke(IS),and to construct and validate a risk prediction model for post-stroke cognitive impairment(PSCI).Methods A total of 408 patients with first IS diagnosed at a third-level grade A hospital of integrated traditional Chinese and Western medicine in Shanghai from February 2020 to February 2022 by convenience sampling method was selected and followed up for 6 months,and were divided into training sets(n=286)and internal validation sets(n=122).The patients admitted to another third-level grade A hospital of integrated traditional Chinese and Western medicine in March 2022 were used as the external validation group(n=55).logistic regression analysis was used to screen the risk factors for cognitive impairment in patients with first IS.The nomogram model was constructed using R soft-ware,and the prediction effect was evaluated using the area under the curve(AUC)of receiver operating characteris-tic(ROC),C statistic,and calibration curve.Results The constructed model was Y=ez/(1+ez),where z=-9.346+0.101 × age+0.039 × Hcy+0.248 × NIHSS score+1.499 × temporal lobe infarction+1.626 × qi-xu syndrome.The AUC of model's ROC was 0.853 with 95％CI of 0.807-0.898,the optimal cutoff value was 0.503,the sensi-tivity was 74.8％,the specificity was 87.1％,and the accuracy was 80.1％.The C statistics for internal and exter-nal validation were 0.842(95％CI was 0.817-0.867)and 0.735(95％CI was 0.643-0.826),respectively,and the Brier scores were both less than 0.25.The calibration curve and DCA curve showed that the model had good fit-ting.Conclusion The risk prediction model constructed in this study has good discriminatory power and calibration,which can assist medical staff in screening high-risk populations for post-stroke cognitive impairment and provide ref-erence for early identification and management intervention.
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