Zhang Wen-Bo, Tang Tian-Chi, Zhang An-Ke, Zhang Zhong-Yuan, Hu Qiu-Si, Shen Zhi-Peng, Chen Zhi-Lin
Department of Neurosurgery, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health.
Departments of Neurosurgery.
Neurologist. 2023 Jan 1;28(1):19-24. doi: 10.1097/NRL.0000000000000434.
Stroke-associated pneumonia (SAP) has been found as a common complication in acute ischemic stroke (AIS) patients. Large artery atherosclerosis (LAA) infarct is a major subtype of AIS. This study aimed to build a clinical prediction model for SAP of LAA type AIS patients.
This study included 295 patients with LAA type AIS. Univariate analyses and logistic regression analyses were conducted to determine the independent predictors for the modeling purpose. Nomogram used receiver operating characteristics to assess the accuracy of the model, and the calibration plots were employed to assess the fitting degree between the model and the practical scenario. One hundred and five patients were employed for the external validation to test the stability of the model.
From the univariate analysis, patients' ages, neutrophil-to-lymphocyte ratios, National Institute of Health Stroke scale (NIHSS) scores, red blood cell, sex, history of coronary artery disease, stroke location and volume-viscosity swallow test showed statistical difference in the development group for the occurrence of SAP. By incorporating the factors above into a multivariate logistic regression analysis, patients' ages, neutrophil-to-lymphocyte ratios, NIHSS, and volume-viscosity swallow test emerged as the independent risk factors of the development of SAP. The nomogram based on the mentioned 4 variables above achieved a receiver operating characteristic of 0.951 and a validation group of 0.946.
The proposed nomogram is capable of predicting predict the occurrence of SAP in LAA type AIS patients, and it may identify high-risk patients in time and present information for in-depth treatment.
卒中相关性肺炎(SAP)是急性缺血性卒中(AIS)患者常见的并发症。大动脉粥样硬化(LAA)梗死是AIS的主要亚型。本研究旨在构建LAA型AIS患者SAP的临床预测模型。
本研究纳入295例LAA型AIS患者。进行单因素分析和逻辑回归分析以确定用于建模的独立预测因素。列线图使用受试者工作特征曲线评估模型的准确性,并采用校准图评估模型与实际情况的拟合度。105例患者用于外部验证以测试模型的稳定性。
单因素分析显示,患者年龄、中性粒细胞与淋巴细胞比值、美国国立卫生研究院卒中量表(NIHSS)评分、红细胞、性别、冠状动脉疾病史、卒中部位和容量 - 黏度吞咽试验在SAP发生的发展组中有统计学差异。通过将上述因素纳入多因素逻辑回归分析,患者年龄、中性粒细胞与淋巴细胞比值、NIHSS和容量 - 黏度吞咽试验成为SAP发生的独立危险因素。基于上述4个变量的列线图受试者工作特征曲线下面积为0.951,验证组为0.946。
所提出的列线图能够预测LAA型AIS患者SAP的发生,它可能及时识别高危患者并为深入治疗提供信息。