Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram
BackgroundThis study aimed to establish and validate an easy-to-use nomogram for predicting long-term mortality among ischemic stroke patients.MethodsAll raw data were obtained from the Medical Information Mart for Intensive Care IV database. Clinical features associated with long-term mortality (1-...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1148185/full |
| _version_ | 1797847190181249024 |
|---|---|
| author | Guangyong Jin Wei Hu Longhuan Zeng Buqing Ma Menglu Zhou |
| author_facet | Guangyong Jin Wei Hu Longhuan Zeng Buqing Ma Menglu Zhou |
| author_sort | Guangyong Jin |
| collection | DOAJ |
| description | BackgroundThis study aimed to establish and validate an easy-to-use nomogram for predicting long-term mortality among ischemic stroke patients.MethodsAll raw data were obtained from the Medical Information Mart for Intensive Care IV database. Clinical features associated with long-term mortality (1-year mortality) among ischemic stroke patients were identified using least absolute shrinkage and selection operator regression. Then, binary logistic regression was used to construct a nomogram, the discrimination of which was evaluated by the concordance index (C-index), integrated discrimination improvement (IDI), and net reclassification index (NRI). Finally, a calibration curve and decision curve analysis (DCA) were employed to study calibration and net clinical benefit, compared to the Glasgow Coma Scale (GCS) and the commonly used disease severity scoring system.ResultsPatients who were identified with ischemic stroke were randomly assigned into developing (n = 1,443) and verification (n = 646) cohorts. The following factors were associated with 1-year mortality among ischemic stroke patients, including age on ICU admission, marital status, underlying dementia, underlying malignant cancer, underlying metastatic solid tumor, heart rate, respiratory rate, oxygen saturation, white blood cells, anion gap, mannitol injection, invasive mechanical ventilation, and GCS. The construction of the nomogram was based on the abovementioned features. The C-index of the nomogram in the developing and verification cohorts was 0.820 and 0.816, respectively. Compared with GCS and the commonly used disease severity scoring system, the IDI and NRI of the constructed nomogram had a statistically positive improvement in predicting long-term mortality in both developing and verification cohorts (all with p < 0.001). The actual mortality was consistent with the predicted mortality in the developing (p = 0.862) and verification (p = 0.568) cohorts. Our nomogram exhibited greater net clinical benefit than GCS and the commonly used disease severity scoring system.ConclusionThis proposed nomogram has good performance in predicting long-term mortality among ischemic stroke patients. |
| first_indexed | 2024-04-09T18:07:18Z |
| format | Article |
| id | doaj.art-d8b8a34e173c4ca0b8cce2b80428c0f7 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T18:07:18Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d8b8a34e173c4ca0b8cce2b80428c0f72023-04-14T05:36:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11481851148185Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogramGuangyong Jin0Wei Hu1Longhuan Zeng2Buqing Ma3Menglu Zhou4Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Neurology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, ChinaBackgroundThis study aimed to establish and validate an easy-to-use nomogram for predicting long-term mortality among ischemic stroke patients.MethodsAll raw data were obtained from the Medical Information Mart for Intensive Care IV database. Clinical features associated with long-term mortality (1-year mortality) among ischemic stroke patients were identified using least absolute shrinkage and selection operator regression. Then, binary logistic regression was used to construct a nomogram, the discrimination of which was evaluated by the concordance index (C-index), integrated discrimination improvement (IDI), and net reclassification index (NRI). Finally, a calibration curve and decision curve analysis (DCA) were employed to study calibration and net clinical benefit, compared to the Glasgow Coma Scale (GCS) and the commonly used disease severity scoring system.ResultsPatients who were identified with ischemic stroke were randomly assigned into developing (n = 1,443) and verification (n = 646) cohorts. The following factors were associated with 1-year mortality among ischemic stroke patients, including age on ICU admission, marital status, underlying dementia, underlying malignant cancer, underlying metastatic solid tumor, heart rate, respiratory rate, oxygen saturation, white blood cells, anion gap, mannitol injection, invasive mechanical ventilation, and GCS. The construction of the nomogram was based on the abovementioned features. The C-index of the nomogram in the developing and verification cohorts was 0.820 and 0.816, respectively. Compared with GCS and the commonly used disease severity scoring system, the IDI and NRI of the constructed nomogram had a statistically positive improvement in predicting long-term mortality in both developing and verification cohorts (all with p < 0.001). The actual mortality was consistent with the predicted mortality in the developing (p = 0.862) and verification (p = 0.568) cohorts. Our nomogram exhibited greater net clinical benefit than GCS and the commonly used disease severity scoring system.ConclusionThis proposed nomogram has good performance in predicting long-term mortality among ischemic stroke patients.https://www.frontiersin.org/articles/10.3389/fneur.2023.1148185/fullintensive care unitischemic strokeMIMIC-IVmortalitynomogramprediction model |
| spellingShingle | Guangyong Jin Wei Hu Longhuan Zeng Buqing Ma Menglu Zhou Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram Frontiers in Neurology intensive care unit ischemic stroke MIMIC-IV mortality nomogram prediction model |
| title | Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram |
| title_full | Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram |
| title_fullStr | Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram |
| title_full_unstemmed | Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram |
| title_short | Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram |
| title_sort | prediction of long term mortality in patients with ischemic stroke based on clinical characteristics on the first day of icu admission an easy to use nomogram |
| topic | intensive care unit ischemic stroke MIMIC-IV mortality nomogram prediction model |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1148185/full |
| work_keys_str_mv | AT guangyongjin predictionoflongtermmortalityinpatientswithischemicstrokebasedonclinicalcharacteristicsonthefirstdayoficuadmissionaneasytousenomogram AT weihu predictionoflongtermmortalityinpatientswithischemicstrokebasedonclinicalcharacteristicsonthefirstdayoficuadmissionaneasytousenomogram AT longhuanzeng predictionoflongtermmortalityinpatientswithischemicstrokebasedonclinicalcharacteristicsonthefirstdayoficuadmissionaneasytousenomogram AT buqingma predictionoflongtermmortalityinpatientswithischemicstrokebasedonclinicalcharacteristicsonthefirstdayoficuadmissionaneasytousenomogram AT mengluzhou predictionoflongtermmortalityinpatientswithischemicstrokebasedonclinicalcharacteristicsonthefirstdayoficuadmissionaneasytousenomogram |