Monday, June 10, 2024

The rate-pressure product combined model within 24 h on admission predicts the 30-day mortality rate in conservatively treated patients with intracerebral hemorrhage

 If you're not going to do useful research like delivering recovery or preventing mortality instead of this crapola of predicting failure to recover, I'd suggest getting the hell out of stroke and doing something easier like basket weaving.

The rate-pressure product combined model within 24 h on admission predicts the 30-day mortality rate in conservatively treated patients with intracerebral hemorrhage

Hui ZhengHui ZhengYuguang TangYuguang TangHai ZhouHai ZhouXiang Ji
Xiang Ji*
  • Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

Background and objectives: Recently, some literature has proposed new indicators such as rate-pressure product, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, etc. However, there has been no literature that has utilized these new indicators to establish a predictive model for assessing the risk of mortality in patients within 24 h on admission. Therefore, this study aims to build a predictive model that can rapidly assess the likelihood of mortality in patients within 24 h of admission.

Methods: The datasets used in this study are available from the corresponding author upon reasonable request. Patients were randomly assigned to the training or validation cohort based on a ratio of 7:3, which was implemented as internal validations for the final predictive models. In the training set, least absolute shrinkage and selection operator (LASSO) regression was employed to select predictive factors, followed by both univariate and subsequent multivariate analysis. The predictive ability was assessed by the area under the receiver operating characteristic (ROC) curve.

Results: A total of 428 patients were included in our research. The final model included 4 independent predictors (Glasgow Coma Scale, hematoma volume, rate-pressure product, c-reactive protein) and was developed as a simple-to-use nomogram. The training set and internal validation set model’s C-index are 0.933 and 0.954, demonstrating moderate predictive ability with regard to risks of mortality. Compared to ICH score (AUC: 0.910 and 0.925), the net reclassification index (NRI) is 0.298 (CI = −0.105 to 0.701, p: 0.147) and integrated discrimination improvement (IDI) is 0.089 (CI = −0.049 to 0.228, p: 0.209). Our model is equally excellent as the classic ICH score model.

Conclusion: We developed a model with four independent risk factors to predict the mortality of ICH patients. Our predictive model is effective in assessing the risk of mortality in patients within 24 h on admission, which might be worth considering in clinical settings after further external validation.

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