Li Xiang, Wang Fusang, Zhao Zhihong, Sun Chao, Liao Jun, Li Xuemei, Huang Chaoping, Nyame Linda, Zhao Zheng, Zheng Xiaohan, Zhou Junshan, Li Ming, Zou Jianjun
School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Front Neurol. 2020 Jun 30;11:531. doi: 10.3389/fneur.2020.00531. eCollection 2020.
Accurate prediction of functional outcomes after stroke would provide evidence for reasonable poststroke management. This study aimed to develop and validate a nomogram for individualized prediction of 1-year unfavorable outcomes in Chinese acute ischemic stroke (AIS) patients. We gathered AIS patients at the National Advanced Stroke Center of Nanjing First Hospital (China) between August 2014 and May 2017 within 12 h of symptom onset. The outcome measure was 1-year unfavorable outcomes (modified Rankin Scale 3-6). The patients were randomly stratified into the training (66.7%) and testing (33.3%) sets. With the training data, pre-established predictors were entered into a logistic regression model to generate the nomogram. Predictive performance of the nomogram model was evaluated in the testing data by calculating the area under the receiver operating characteristic curve (AUC-ROC), Brier score, and a calibration plot. A total of 807 patients were included into this study, and 262 (32.5%) of them had unfavorable outcomes. Systolic blood pressure, Creatinine, Age, National Institutes of Health Stroke Scale (NIHSS) score on admission, and fasting blood glucose were significantly associated with unfavorable outcomes and entered into the SCANO nomogram. The AUC-ROC of the SCANO nomogram in the testing set was 0.781 (Brier score: 0.166; calibration slope: 0.936; calibration intercept: 0.060). The SCANO nomogram is developed and validated in Chinese AIS patients to firstly predict 1-year unfavorable outcomes, which is simple and convenient for the management of stroke patients.
准确预测卒中后的功能结局可为合理的卒中后管理提供依据。本研究旨在开发并验证一种列线图,用于个体化预测中国急性缺血性卒中(AIS)患者1年时的不良结局。我们于2014年8月至2017年5月在中国南京医科大学第一附属医院国家高级卒中中心收集了症状发作12小时内的AIS患者。结局指标为1年时的不良结局(改良Rankin量表评分3 - 6分)。患者被随机分层为训练集(66.7%)和测试集(33.3%)。利用训练数据,将预先设定的预测因素纳入逻辑回归模型以生成列线图。通过计算受试者工作特征曲线下面积(AUC - ROC)、Brier评分和校准图,在测试数据中评估列线图模型的预测性能。本研究共纳入807例患者,其中262例(32.5%)有不良结局。收缩压、肌酐、年龄、入院时美国国立卫生研究院卒中量表(NIHSS)评分和空腹血糖与不良结局显著相关,并被纳入SCANO列线图。SCANO列线图在测试集中的AUC - ROC为0.781(Brier评分:0.166;校准斜率:0.936;校准截距:0.060)。SCANO列线图在中国AIS患者中得到开发和验证,首次用于预测1年时的不良结局,对卒中患者的管理简单方便。