Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke
BackgroundHemorrhagic transformation (HT) after intravenous thrombolysis (IVT) might worsen the clinical outcomes, and a reliable predictive system is needed to identify the risk of hemorrhagic transformation after IVT.MethodsRetrospective collection of patients with acute cerebral infarction treate...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1361035/full |
| _version_ | 1827323862373629952 |
|---|---|
| author | Yong Ma Yong Ma Dong-Yan Xu Qian Liu He-Cheng Chen Er-Qing Chai |
| author_facet | Yong Ma Yong Ma Dong-Yan Xu Qian Liu He-Cheng Chen Er-Qing Chai |
| author_sort | Yong Ma |
| collection | DOAJ |
| description | BackgroundHemorrhagic transformation (HT) after intravenous thrombolysis (IVT) might worsen the clinical outcomes, and a reliable predictive system is needed to identify the risk of hemorrhagic transformation after IVT.MethodsRetrospective collection of patients with acute cerebral infarction treated with intravenous thrombolysis in our hospital from 2018 to 2022. 197 patients were included in the research study. Multivariate logistic regression analysis was used to screen the factors in the predictive nomogram. The performance of nomogram was assessed on the area under the receiver operating characteristic curve (AUC-ROC), calibration plots and decision curve analysis (DCA).ResultsA total of 197 patients were recruited, of whom 24 (12.1%) developed HT. In multivariate logistic regression model National Institute of Health Stroke Scale (NIHSS) (OR, 1.362; 95% CI, 1.161–1.652; p = 0.001), N-terminal pro-brain natriuretic peptide (NT-pro BNP) (OR, 1.012; 95% CI, 1.004–1.020; p = 0.003), neutrophil to lymphocyte ratio (NLR) (OR, 3.430; 95% CI, 2.082–6.262; p < 0.001), systolic blood pressure (SBP) (OR, 1.039; 95% CI, 1.009–1.075; p = 0.016) were the independent predictors of HT which were used to generate nomogram. The nomogram showed good discrimination due to AUC-ROC values. Calibration plot showed good calibration. DCA showed that nomogram is clinically useful.ConclusionNomogram consisting of NIHSS, NT-pro BNP, NLR, SBP scores predict the risk of HT in AIS patients treated with IVT. |
| first_indexed | 2024-04-25T01:59:26Z |
| format | Article |
| id | doaj.art-4885047bed1b4a21a09807ee891626ae |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-25T01:59:26Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4885047bed1b4a21a09807ee891626ae2024-03-07T15:12:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-03-011510.3389/fneur.2024.13610351361035Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic strokeYong Ma0Yong Ma1Dong-Yan Xu2Qian Liu3He-Cheng Chen4Er-Qing Chai5Ningxia Medical University, Yinchuan, ChinaCerebrovascular Disease Centre, Gansu Provincial People’s Hospital, Lanzhou, ChinaDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, ChinaCerebrovascular Disease Centre, Gansu Provincial People’s Hospital, Lanzhou, ChinaCerebrovascular Disease Centre, Gansu Provincial People’s Hospital, Lanzhou, ChinaCerebrovascular Disease Centre, Gansu Provincial People’s Hospital, Lanzhou, ChinaBackgroundHemorrhagic transformation (HT) after intravenous thrombolysis (IVT) might worsen the clinical outcomes, and a reliable predictive system is needed to identify the risk of hemorrhagic transformation after IVT.MethodsRetrospective collection of patients with acute cerebral infarction treated with intravenous thrombolysis in our hospital from 2018 to 2022. 197 patients were included in the research study. Multivariate logistic regression analysis was used to screen the factors in the predictive nomogram. The performance of nomogram was assessed on the area under the receiver operating characteristic curve (AUC-ROC), calibration plots and decision curve analysis (DCA).ResultsA total of 197 patients were recruited, of whom 24 (12.1%) developed HT. In multivariate logistic regression model National Institute of Health Stroke Scale (NIHSS) (OR, 1.362; 95% CI, 1.161–1.652; p = 0.001), N-terminal pro-brain natriuretic peptide (NT-pro BNP) (OR, 1.012; 95% CI, 1.004–1.020; p = 0.003), neutrophil to lymphocyte ratio (NLR) (OR, 3.430; 95% CI, 2.082–6.262; p < 0.001), systolic blood pressure (SBP) (OR, 1.039; 95% CI, 1.009–1.075; p = 0.016) were the independent predictors of HT which were used to generate nomogram. The nomogram showed good discrimination due to AUC-ROC values. Calibration plot showed good calibration. DCA showed that nomogram is clinically useful.ConclusionNomogram consisting of NIHSS, NT-pro BNP, NLR, SBP scores predict the risk of HT in AIS patients treated with IVT.https://www.frontiersin.org/articles/10.3389/fneur.2024.1361035/fullacute ischemic strokeintravenous thrombolysishemorrhagic transformationnomogramNLR |
| spellingShingle | Yong Ma Yong Ma Dong-Yan Xu Qian Liu He-Cheng Chen Er-Qing Chai Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke Frontiers in Neurology acute ischemic stroke intravenous thrombolysis hemorrhagic transformation nomogram NLR |
| title | Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| title_full | Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| title_fullStr | Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| title_full_unstemmed | Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| title_short | Nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| title_sort | nomogram prediction model for the risk of intracranial hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke |
| topic | acute ischemic stroke intravenous thrombolysis hemorrhagic transformation nomogram NLR |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1361035/full |
| work_keys_str_mv | AT yongma nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke AT yongma nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke AT dongyanxu nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke AT qianliu nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke AT hechengchen nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke AT erqingchai nomogrampredictionmodelfortheriskofintracranialhemorrhagictransformationafterintravenousthrombolysisinpatientswithacuteischemicstroke |