Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion

Objectives: Patients with anterior circulation large vessel occlusion are at high risk of acute ischemic stroke, which could be disabling or fatal. In this study, we applied machine learning to develop and validate two prediction models for acute ischemic stroke (Model 1) and severity of neurologica...

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Main Authors: Junzhao Cui, Jingyi Yang, Kun Zhang, Guodong Xu, Ruijie Zhao, Xipeng Li, Luji Liu, Yipu Zhu, Lixia Zhou, Ping Yu, Lei Xu, Tong Li, Jing Tian, Pandi Zhao, Si Yuan, Qisong Wang, Li Guo, Xiaoyun Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-12-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2021.749599/full
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author Junzhao Cui
Jingyi Yang
Kun Zhang
Guodong Xu
Ruijie Zhao
Xipeng Li
Luji Liu
Yipu Zhu
Lixia Zhou
Ping Yu
Lei Xu
Tong Li
Jing Tian
Pandi Zhao
Si Yuan
Qisong Wang
Li Guo
Xiaoyun Liu
Xiaoyun Liu
author_facet Junzhao Cui
Jingyi Yang
Kun Zhang
Guodong Xu
Ruijie Zhao
Xipeng Li
Luji Liu
Yipu Zhu
Lixia Zhou
Ping Yu
Lei Xu
Tong Li
Jing Tian
Pandi Zhao
Si Yuan
Qisong Wang
Li Guo
Xiaoyun Liu
Xiaoyun Liu
author_sort Junzhao Cui
collection DOAJ
description Objectives: Patients with anterior circulation large vessel occlusion are at high risk of acute ischemic stroke, which could be disabling or fatal. In this study, we applied machine learning to develop and validate two prediction models for acute ischemic stroke (Model 1) and severity of neurological impairment (Model 2), both caused by anterior circulation large vessel occlusion (AC-LVO), based on medical history and neuroimaging data of patients on admission.Methods: A total of 1,100 patients with AC- LVO from the Second Hospital of Hebei Medical University in North China were enrolled, of which 713 patients presented with acute ischemic stroke (AIS) related to AC- LVO and 387 presented with the non-acute ischemic cerebrovascular event. Among patients with the non-acute ischemic cerebrovascular events, 173 with prior stroke or TIA were excluded. Finally, 927 patients with AC-LVO were entered into the derivation cohort. In the external validation cohort, 150 patients with AC-LVO from the Hebei Province People's Hospital, including 99 patients with AIS related to AC- LVO and 51 asymptomatic AC-LVO patients, were retrospectively reviewed. We developed four machine learning models [logistic regression (LR), regularized LR (RLR), support vector machine (SVM), and random forest (RF)], whose performance was internally validated using 5-fold cross-validation. The performance of each machine learning model for the area under the receiver operating characteristic curve (ROC-AUC) was compared and the variables of each algorithm were ranked.Results: In model 1, among the included patients with AC-LVO, 713 (76.9%) and 99 (66%) suffered an acute ischemic stroke in the derivation and external validation cohorts, respectively. The ROC-AUC of LR, RLR and SVM were significantly higher than that of the RF in the external validation cohorts [0.66 (95% CI 0.57–0.74) for LR, 0.66 (95% CI 0.57–0.74) for RLR, 0.55 (95% CI 0.45–0.64) for RF and 0.67 (95% CI 0.58–0.76) for SVM]. In model 2, 254 (53.9%) and 31 (37.8%) patients suffered disabling ischemic stroke in the derivation and external validation cohorts, respectively. There was no difference in AUC among the four machine learning algorithms in the external validation cohorts.Conclusions: Machine learning methods with multiple clinical variables have the ability to predict acute ischemic stroke and the severity of neurological impairment in patients with AC-LVO.
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spelling doaj.art-f6014f0c89214bd2b22a759e6578ce2f2022-12-21T23:00:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-12-011210.3389/fneur.2021.749599749599Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel OcclusionJunzhao Cui0Jingyi Yang1Kun Zhang2Guodong Xu3Ruijie Zhao4Xipeng Li5Luji Liu6Yipu Zhu7Lixia Zhou8Ping Yu9Lei Xu10Tong Li11Jing Tian12Pandi Zhao13Si Yuan14Qisong Wang15Li Guo16Xiaoyun Liu17Xiaoyun Liu18Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Information Center, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, Hebei Province People's Hospital, Shijiazhuang, ChinaDepartment of Neurology, Xingtai People's Hospital, Xingtai, ChinaDepartment of Neurology, Xingtai People's Hospital, Xingtai, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Medical Iconography, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, ChinaNeuroscience Research Center, Medicine and Health Institute, Hebei Medical University, Shijiazhuang, ChinaObjectives: Patients with anterior circulation large vessel occlusion are at high risk of acute ischemic stroke, which could be disabling or fatal. In this study, we applied machine learning to develop and validate two prediction models for acute ischemic stroke (Model 1) and severity of neurological impairment (Model 2), both caused by anterior circulation large vessel occlusion (AC-LVO), based on medical history and neuroimaging data of patients on admission.Methods: A total of 1,100 patients with AC- LVO from the Second Hospital of Hebei Medical University in North China were enrolled, of which 713 patients presented with acute ischemic stroke (AIS) related to AC- LVO and 387 presented with the non-acute ischemic cerebrovascular event. Among patients with the non-acute ischemic cerebrovascular events, 173 with prior stroke or TIA were excluded. Finally, 927 patients with AC-LVO were entered into the derivation cohort. In the external validation cohort, 150 patients with AC-LVO from the Hebei Province People's Hospital, including 99 patients with AIS related to AC- LVO and 51 asymptomatic AC-LVO patients, were retrospectively reviewed. We developed four machine learning models [logistic regression (LR), regularized LR (RLR), support vector machine (SVM), and random forest (RF)], whose performance was internally validated using 5-fold cross-validation. The performance of each machine learning model for the area under the receiver operating characteristic curve (ROC-AUC) was compared and the variables of each algorithm were ranked.Results: In model 1, among the included patients with AC-LVO, 713 (76.9%) and 99 (66%) suffered an acute ischemic stroke in the derivation and external validation cohorts, respectively. The ROC-AUC of LR, RLR and SVM were significantly higher than that of the RF in the external validation cohorts [0.66 (95% CI 0.57–0.74) for LR, 0.66 (95% CI 0.57–0.74) for RLR, 0.55 (95% CI 0.45–0.64) for RF and 0.67 (95% CI 0.58–0.76) for SVM]. In model 2, 254 (53.9%) and 31 (37.8%) patients suffered disabling ischemic stroke in the derivation and external validation cohorts, respectively. There was no difference in AUC among the four machine learning algorithms in the external validation cohorts.Conclusions: Machine learning methods with multiple clinical variables have the ability to predict acute ischemic stroke and the severity of neurological impairment in patients with AC-LVO.https://www.frontiersin.org/articles/10.3389/fneur.2021.749599/fullanterior circulation large vessel occlusionacute ischemic strokemachine learningprediction modelneurological impairment
spellingShingle Junzhao Cui
Jingyi Yang
Kun Zhang
Guodong Xu
Ruijie Zhao
Xipeng Li
Luji Liu
Yipu Zhu
Lixia Zhou
Ping Yu
Lei Xu
Tong Li
Jing Tian
Pandi Zhao
Si Yuan
Qisong Wang
Li Guo
Xiaoyun Liu
Xiaoyun Liu
Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
Frontiers in Neurology
anterior circulation large vessel occlusion
acute ischemic stroke
machine learning
prediction model
neurological impairment
title Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
title_full Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
title_fullStr Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
title_full_unstemmed Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
title_short Machine Learning-Based Model for Predicting Incidence and Severity of Acute Ischemic Stroke in Anterior Circulation Large Vessel Occlusion
title_sort machine learning based model for predicting incidence and severity of acute ischemic stroke in anterior circulation large vessel occlusion
topic anterior circulation large vessel occlusion
acute ischemic stroke
machine learning
prediction model
neurological impairment
url https://www.frontiersin.org/articles/10.3389/fneur.2021.749599/full
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