Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Thorac Cancer. 2022 Oct;13(19):2751-2758. doi: 10.1111/1759-7714.14611. Epub 2022 Aug 18.
To investigate the independent risk factors of poor short-term outcomes in patients with lung cancer-associated acute ischemic stroke (LCAIS) and use them to develop an index of prognosis LCAIS (pLCAIS) which could help clinicians identify patients at high risk for poor short-term outcomes.
We retrospectively enrolled patients with lung cancer-associated acute ischemic stroke and employed the 90D modified Rankin cale (mRS) to divide them into two groups: good outcomes (score 0-2) and poor outcomes (score 3-6). Propensity score matching (PSM) was used to remove confounding factors, and multivariable logistic regression analysis was used to analyze the independent risk factors of pLCAIS. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) developed a multiple model combining the independent risk factors of pLCAIS.
A total of 172 patients were included: 67 (38.9%) with good outcomes and 105 (61.1%) with poor outcomes. After using PSM, there were 33 cases in each group. The results showed that patients with poor short-term outcomes were significantly higher in D-dimer (OR = 1.001, 95% CI: 1.000-1.002, p = 0.048), CRP (OR = 1.078, 95% CI: 1.008-1.153, p = 0.028), and neutrophil count (OR = 14.673, 95% CI: 1.802-19.500, p = 0.012). The ROC curve, used to assess the diagnostic ability of binary classifiers, showed that the product of these three independent risk factors showed high sensitivity and specificity.
In this study, we have identified three independent risk factors associated with poor short-term outcomes in pLCAIS: higher NC, CRP, and D-dimer levels. These findings may be helpful for clinicians in identifying poor short-term outcomes patients.
本研究旨在探讨肺癌相关性急性缺血性卒中(LCAIS)患者短期预后不良的独立危险因素,并建立预后 LCAIS 指数(pLCAIS)以帮助临床医生识别短期预后不良的高危患者。
回顾性纳入 LCAIS 患者,采用 90 天改良 Rankin 量表(mRS)评分将患者分为预后良好组(评分 0-2 分)和预后不良组(评分 3-6 分)。采用倾向评分匹配(PSM)消除混杂因素,多因素 logistic 回归分析 pLCAIS 的独立危险因素。通过绘制受试者工作特征(ROC)曲线和计算曲线下面积(AUC),构建 pLCAIS 独立危险因素的联合模型。
共纳入 172 例患者,其中预后良好 67 例(38.9%),预后不良 105 例(61.1%)。PSM 后每组各 33 例。结果显示,预后不良组患者 D-二聚体(OR=1.001,95%CI:1.000-1.002,p=0.048)、C 反应蛋白(OR=1.078,95%CI:1.008-1.153,p=0.028)和中性粒细胞计数(OR=14.673,95%CI:1.802-19.500,p=0.012)均显著高于预后良好组。ROC 曲线评估二分类诊断效能显示,三者乘积联合模型具有较高的灵敏度和特异度。
本研究确定了与 pLCAIS 短期预后不良相关的三个独立危险因素:较高的中性粒细胞计数、C 反应蛋白和 D-二聚体水平。这些发现可能有助于临床医生识别短期预后不良的患者。