Construction of short-term prognostic nomogram model for type 2 diabetes patients with acute ischemic stroke after thrombolysis
Objective To analyze the influencing factors of short-term prognosis deterioration within 24 hours after thrombolysis in patients with type 2 diabetes mellitus(T2DM)and acute ischemic stroke(AIS),and establish a nomogram prediction model on this basis.Methods A total of 283 patients with AIS admitted to our hospital from January 2019 to May 2023 were selected.Multivariate logistic regression analysis was used to analyze the factors affecting the short-term prognosis of T2DM patients with AIS after thrombolysis.On this basis,a nomogram model was established.ROC curve,calibration curve,decision curve and clinical impact curve were used to verify the predictive ability of the model.Results The blood glucose levels in the T2DM+AIS group were higher than those in the AIS group,and the short-term prognosis of the T2DM+AIS group was worse than that of the AIS group(P＜0.05).The results of multivariate binary logistic regression analysis showed that glycosylated hemoglobin(HbA1c)and homocysteine(Hey)were risk factors for short-term deterioration of prognosis in T2DM+AIS patients.The short-term prognosis deterioration is sig-nificantly positively correlated with HbA1c and Hey.The area under the ROC curves for HbA1c and Hey predicting the short-term prognosis deterioration was 0.808 and 0.804,respectively.The optimal cutoff values are 7.55％and 15.55 µmol/L.The sensitivity was 88.0％and 58.0％.The specificity was 60.0％and 96.2％.The area under the ROC curves of the constructed nomogram was 0.879,with a sensitivity of 82.0％and a specificity of 86.2％.Conclusions HbA1 c and Hey are risk factors for T2DM patients with AIS after thrombolysis.The two indicators can predict short-term prognosis within 24 hours after thrombolysis.The constructed nomogram model has a good predictive evaluation value.It can provide a certain reference for screening high-risk populations in clinical practice.
Type 2 diabetesAcute ischemic strokeGlycated hemoglobinHomocysteineNIHSS score
万方数据
维普
