Study on risk factors and risk prediction model of poor prognosis in patients with acute ischemic stroke(AIS)complicated with cerebrocardiac syndrome(CCS)
Objective To investigate the risk factors of death from acute ischemic stroke(AIS)complicated with cerebrocardiac syndrome(CCS),and to construct a risk prediction model.Methods 203 patients with AIS combined with CCS admitted to the hospital from June 2020 to December 2023 were selected as the research objects.General information of the patients was collected through the electronic medical re-cord information system.After 6 months of follow-up,the patients were divided into death group(n=57)and survival group(n=146)according to the prognosis.The clinical data of the 2 groups were compared,the risk factors of the patient death were identified by multi-factor Logistic regression analysis,the inde-pendent risk factors were introduced into R software to build the risk nomogram,and the model differenti-ation was verified by Bootstrap method.Calibration curve and receiver operating characteristic(ROC)curve were drawn to evaluate the fit and prediction efficiency.Results Compared to the death group,ar-rhythmia ratio,ST segment change ratio,National Institutes of Health Stroke Scale(NIHSS)score,CCS duration,white blood cell count(WBC),glycosylated hemoglobin(HbA1c),blood lactate(Lac),serum creatine kinase(CK),creatine kinase isoenzyme(CK-MB),cardiac troponin T(cTn)and B natriuretic peptide(BNP)levels were decreased in survival group,but left ventricular ejection fraction(LVEF)val-ues were increased,the difference was statistically significant(P＜0.05).Multivariate Logistic regression model showed that the presence of arrhythmia,high level of Lac,CK-MB and cTnT were independent risk factors for death in AIS patients with CCS,while high LVEF was a protective factor for good prognosis(P＜0.05).The prediction model equation of AIS patients with CCS was established based on independent risk factors.Bootstrap method was used to verify the prediction model internally.Calibration curve showed that the model had a good fit.The AUC of the prediction model based on AIS combined with CCS patient mortality risk factors was 0.951(95％CI:0.920～0.981,P＜0.05),indicating better predictive efficacy.Conclusion Arrhythmias,high levels of Lac,CK-MB and cTnT are risk factors for death in AIS patients with CCS,while high levels of LVEF are protective factors for good prognosis.The risk predic-tion model built based on the factors affecting the death of thepatients with AIS combined with CCS within 6 months has better efficacy,and it provides high clinical value for carrying out active intervention and im-proving prognosis.
acute ischemic stroke(AIS)brain-heart syndromeprognosisrisk factorsprediction model
万方数据
维普
