Deans' stroke musings: A clinically applicable nomogram predicting non-return to work in young and middle-aged patients with acute large vessel occlusion stroke: integrating neurological function and psychosocial factors for personalized rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, June 29, 2026

A clinically applicable nomogram predicting non-return to work in young and middle-aged patients with acute large vessel occlusion stroke: integrating neurological function and psychosocial factors for personalized rehabilitation

What fucking stupidity, predicting failure to return to work; RATHER THAN DELIVERING PROTOCOLS THAT GET YOU RECOVERED! You're all fired! Hope your comeuppance hits you really really hard when you become the 1 in 4 per WHO that has a stroke!

A clinically applicable nomogram predicting non-return to work in young and middle-aged patients with acute large vessel occlusion stroke: integrating neurological function and psychosocial factors for personalized rehabilitation

Yu Ding 1†
Jingling Zhu 1†
Y
Yiling He 1
Xiuling Yang 1
Wenfei Liang 1
K
Kangqiang Yang 1
X
Xiaoling Wu 1
G
Guoshun Li 1
Weimin Ning 1,2,3*

1. Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
2. Dongguan Key Laboratory of Intractable Brain Diseases, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China

Abstract

Objective:

This study was designed to identify key predictors of non-return to work (non-RTW) in young and middle-aged patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) after endovascular therapy (EVT). Based on these predictors, we developed and validated an individualized nomogram for non-RTW risk stratification to facilitate early identification of high-risk patients and guide personalized rehabilitation for better functional recovery and less occupational loss.

Methods:

In this retrospective cohort study, 350 consecutive AIS-LVO patients who underwent EVT at Dongguan Hospital of Traditional Chinese Medicine (July 2018–July 2025) were included. Potential predictors were selected using least absolute shrinkage and selection operator (LASSO) regression, and independent predictors were identified via multivariable logistic regression. A nomogram was constructed and assessed for discrimination using the area under the receiver operating characteristic curve (AUC), for calibration using calibration curves and the Hosmer–Lemeshow test, and for clinical utility via decision curve analysis (DCA).

Results:

Six independent predictors of non-RTW were identified: instrumental activities of daily living (IADL), admission NIHSS score, Nutritional Risk Screening 2002 (NRS-2002) score, balance impairment (as measured by the Berg Balance Scale, BBS), post-stroke rehabilitation (Rehab), and anxiety-depressive state (ADS). The nomogram demonstrated robust discriminative performance (AUC = 0.858, 95% CI: 0.812–0.903). Calibration curves confirmed favorable calibration between predicted and observed probabilities. Decision curve and clinical impact analyses revealed clinically meaningful net benefit across most threshold probabilities.

Conclusion:

We developed and validated a clinically actionable nomogram to predict non-RTW in young and middle-aged AIS-LVO patients after EVT. This tool enables early risk stratification and personalized rehabilitation planning, promoting long-term functional and vocational recovery.