Predictors of early neurological deterioration in patients with acute ischemic stroke

 

You do realize survivors want prevention of early neurological deterioration rather than this USELESS PREDICTION?  I'd have you all fired!

Predictors of early neurological deterioration in patients with acute ischemic stroke

Yang Zhou¹Yufan Luo²Huazheng Liang^3,4,5Zhenyu Wei⁶Xiaofei Ye⁷Ping Zhong^6*Danhong Wu^2*

• ¹Emergency Department, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
• ²Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
• ³Suzhou Industrial Park Monash Research Institute of Science and Technology, Suzhou, Jiangsu Province, China
• ⁴Southeast University-Monash University Joint Graduate School, Suzhou, Jiangsu Province, China
• ⁵Monash University-Southeast University Joint Research Institute, Suzhou, Jiangsu Province, China
• ⁶Department of Neurology, Shanghai Yangpu District Shidong Hospital, Shanghai, China
• ⁷Department of Military Health Statistics, School of Health Service, People's Liberation Army, Naval Medical University, Shanghai, China

Background: The present study aimed to develop a reliable and straightforward Nomogram by integrating various parameters to accurately predict the likelihood of early neurological deterioration (END) in patients with acute ischemic stroke (AIS).

Methods: Acute ischemic stroke patients from Shaoxing People’s Hospital, Shanghai Yangpu District Shidong Hospital, and Shanghai Fifth People’s Hospital were recruited based on specific inclusion and exclusion criteria. The primary outcome was END. Using the LASSO logistic model, a predictive Nomogram was generated. The performance of the Nomogram was evaluated using the ROC curve, the Hosmer-Lemeshow test, and a calibration plot. Additionally, the decision curve analysis was conducted to assess the effectiveness of the Nomogram.

Results: It was found that the Nomogram generated in the present study showed strong discriminatory performance in both the training and the internal validation cohorts when their ROC-AUC values were 0.715 (95% CI 0.648–0.782) and 0.725 (95% CI 0.631–0.820), respectively. Similar results were observed in two external validation cohorts when their ROC-AUC values were 0.685 (95% CI 0.541–0.829) and 0.673 (95% CI 0.545–0.800), respectively. In addition, CAD, SBP, neutrophils, TBil, and LDL were found to be positively correlated with the occurrence of END post-stroke, while lymphocytes and UA were negatively correlated.

Conclusion: Our study developed a novel Nomogram that includes CAD, SBP, neutrophils, lymphocytes, TBil, UA, and LDL and it demonstrated strong discriminatory performance in identifying AIS patients who are likely to develop END.

More at link.