Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis
Zheren Zhou,1,* Xiaoyan Yin,2,3,* Qiuwen Niu,2 Simin Liang,2,4 Chunying Mu,2 Yurong Zhang2 1University Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong Un...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-05-01
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| Series: | Neuropsychiatric Disease and Treatment |
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| Online Access: | https://www.dovepress.com/risk-factors-and-a-nomogram-for-predicting-intracranial-hemorrhage-in--peer-reviewed-article-NDT |
| _version_ | 1819202321423269888 |
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| author | Zhou Z Yin X Niu Q Liang S Mu C Zhang Y |
| author_facet | Zhou Z Yin X Niu Q Liang S Mu C Zhang Y |
| author_sort | Zhou Z |
| collection | DOAJ |
| description | Zheren Zhou,1,* Xiaoyan Yin,2,3,* Qiuwen Niu,2 Simin Liang,2,4 Chunying Mu,2 Yurong Zhang2 1University Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 3Department of Neurology, Wuqi People’s Hospital, Yan’an, Shaanxi, People’s Republic of China; 4Department of Neurology, The First Affiliated Hospital of Xi’an Medical College, Xi’an, Shaanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yurong Zhang Email zhangyurong72@mail.xjtu.edu.cnPurpose: Identifying stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. We aimed to develop and evaluate a nomogram for predicting the probability of ICH in acute ischemic stroke patients undergoing thrombolysis.Patients and Methods: A retrospective observational study was conducted using data from 345 patients at a single center. The patients were randomly dichotomized into training (2/3; n=233) and validation (1/3; n=112) sets. A prediction model was developed by using a multivariable logistic regression analysis.Results: The nomogram comprised three variables: the presence of atrial fibrillation (odds ratio [OR]: 4.92, 95% confidence interval [CI]: 2.09– 11.57), the National Institutes of Health Stroke Scale (NIHSS) score (OR: 1.11, 95% CI: 1.04– 1.18) and the glucose level on admission (OR: 1.27, 95% CI: 1.08– 1.50). The areas under the receiver operating characteristic curve of the nomogram for the training and validation sets were 0.828 (0.753– 0.903) and 0.801 (0.690– 0.911), respectively. The Hosmer–Lemeshow test revealed good calibration in both the training and validation sets (P = 0.509 and P = 0.342, respectively). The calibration plot also demonstrated good agreement. A decision curve analysis demonstrated that the nomogram was clinically useful.Conclusion: We developed an easy-to-use nomogram model to predict ICH, and the nomogram may provide risk assessments for subsequent treatment in stroke patients undergoing thrombolysis.Keywords: stroke, intracranial hemorrhage, thrombolysis, nomogram, prognosis |
| first_indexed | 2024-12-23T04:02:10Z |
| format | Article |
| id | doaj.art-71d3a7f28b8c4f4286491a1af45c03da |
| institution | Directory Open Access Journal |
| issn | 1178-2021 |
| language | English |
| last_indexed | 2024-12-23T04:02:10Z |
| publishDate | 2020-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Neuropsychiatric Disease and Treatment |
| spelling | doaj.art-71d3a7f28b8c4f4286491a1af45c03da2022-12-21T18:00:43ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212020-05-01Volume 161189119753674Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing ThrombolysisZhou ZYin XNiu QLiang SMu CZhang YZheren Zhou,1,* Xiaoyan Yin,2,3,* Qiuwen Niu,2 Simin Liang,2,4 Chunying Mu,2 Yurong Zhang2 1University Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 3Department of Neurology, Wuqi People’s Hospital, Yan’an, Shaanxi, People’s Republic of China; 4Department of Neurology, The First Affiliated Hospital of Xi’an Medical College, Xi’an, Shaanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yurong Zhang Email zhangyurong72@mail.xjtu.edu.cnPurpose: Identifying stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. We aimed to develop and evaluate a nomogram for predicting the probability of ICH in acute ischemic stroke patients undergoing thrombolysis.Patients and Methods: A retrospective observational study was conducted using data from 345 patients at a single center. The patients were randomly dichotomized into training (2/3; n=233) and validation (1/3; n=112) sets. A prediction model was developed by using a multivariable logistic regression analysis.Results: The nomogram comprised three variables: the presence of atrial fibrillation (odds ratio [OR]: 4.92, 95% confidence interval [CI]: 2.09– 11.57), the National Institutes of Health Stroke Scale (NIHSS) score (OR: 1.11, 95% CI: 1.04– 1.18) and the glucose level on admission (OR: 1.27, 95% CI: 1.08– 1.50). The areas under the receiver operating characteristic curve of the nomogram for the training and validation sets were 0.828 (0.753– 0.903) and 0.801 (0.690– 0.911), respectively. The Hosmer–Lemeshow test revealed good calibration in both the training and validation sets (P = 0.509 and P = 0.342, respectively). The calibration plot also demonstrated good agreement. A decision curve analysis demonstrated that the nomogram was clinically useful.Conclusion: We developed an easy-to-use nomogram model to predict ICH, and the nomogram may provide risk assessments for subsequent treatment in stroke patients undergoing thrombolysis.Keywords: stroke, intracranial hemorrhage, thrombolysis, nomogram, prognosishttps://www.dovepress.com/risk-factors-and-a-nomogram-for-predicting-intracranial-hemorrhage-in--peer-reviewed-article-NDTstrokeintracranialhemorrhagethrombolysisnomogramprognosis |
| spellingShingle | Zhou Z Yin X Niu Q Liang S Mu C Zhang Y Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis Neuropsychiatric Disease and Treatment stroke intracranialhemorrhage thrombolysis nomogram prognosis |
| title | Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis |
| title_full | Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis |
| title_fullStr | Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis |
| title_full_unstemmed | Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis |
| title_short | Risk Factors and a Nomogram for Predicting Intracranial Hemorrhage in Stroke Patients Undergoing Thrombolysis |
| title_sort | risk factors and a nomogram for predicting intracranial hemorrhage in stroke patients undergoing thrombolysis |
| topic | stroke intracranialhemorrhage thrombolysis nomogram prognosis |
| url | https://www.dovepress.com/risk-factors-and-a-nomogram-for-predicting-intracranial-hemorrhage-in--peer-reviewed-article-NDT |
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