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伴有深静脉血栓形成的急性缺血性中风患者预测模型的构建与验证

Construction and validation of a prediction model for acute ischemic stroke patients with concomitant deep vein thrombosis.

作者信息

Xu Hai, Yin Qin

机构信息

Ziyang People's Hospital, Ziyang, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2024 Dec 6;103(49):e40754. doi: 10.1097/MD.0000000000040754.

Abstract

The aim was to investigate the independent risk factors for complications of deep vein thrombosis (DVT) in patients with acute ischemic stroke (AIS), and to establish a nomogram prediction model accordingly. The data of AIS patients in our hospital were collected from January 2021 to December 2023, and single-factor and multifactorial logistic regression analyses were used to determine the independent risk factors for the complication of DVT in patients with AIS and to establish the corresponding nomogram. The receiver operating characteristic curves were plotted the area under the curve was calculated, and the calibration and decision curves were plotted to evaluate the model performance. Five hundred twenty-seven AIS patients were included in the study, and 42 AIS patients were complicated with DVT, with an incidence rate of 7.97%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for the complication of DVT in patients with AIS: age > 70 years (OR, 1.551; 95% CI, 1.189-2.751), diabetes (OR, 2.543; 95% CI, 1.322-4.265), the national institutes of health stroke scale > 16 (OR, 3.124; 95% CI, 1.314-7.003), D-dimer > 0.5 mg/L (OR, 2.303; 95% CI, 1.250-3.645), and fibrinogen > 4 g/L (OR, 1.918; 95% CI, 1.532-6.369). The nomogram constructed in this study for AIS patients with concomitant DVT has good predictive accuracy and helps physicians to intervene in advance in patients at high risk of acute AIS patients with concomitant DVT.

摘要

目的是探讨急性缺血性卒中(AIS)患者深静脉血栓形成(DVT)并发症的独立危险因素,并据此建立列线图预测模型。收集我院2021年1月至2023年12月AIS患者的数据,采用单因素和多因素逻辑回归分析确定AIS患者DVT并发症的独立危险因素,并建立相应的列线图。绘制受试者工作特征曲线,计算曲线下面积,并绘制校准曲线和决策曲线以评估模型性能。本研究纳入527例AIS患者,其中42例AIS患者并发DVT,发生率为7.97%。经过单因素和多因素逻辑回归分析,共确定5个变量为AIS患者DVT并发症的独立危险因素:年龄>70岁(OR,1.551;95%CI,1.189 - 2.751)、糖尿病(OR,2.543;95%CI,1.322 - 4.265)、美国国立卫生研究院卒中量表>16分(OR,3.124;95%CI,1.314 - 7.003)、D - 二聚体>0.5mg/L(OR,2.303;95%CI,1.250 - 3.645)和纤维蛋白原>4g/L(OR,1.918;95%CI,1.532 - 6.369)。本研究构建的用于伴发DVT的AIS患者的列线图具有良好的预测准确性,有助于医生对伴发DVT的急性AIS高危患者进行提前干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ee/11630990/9aae59616861/medi-103-e40754-g001.jpg

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