Lou Chen, Xu Dongjuan
Department of Neurology, Dongyang People's Hospital, Affiliated to Wenzhou Medical University, Dongyang, China.
Front Neurol. 2025 Aug 20;16:1452856. doi: 10.3389/fneur.2025.1452856. eCollection 2025.
The purpose of this study was to develop and verify a novel nomogram for predicting stroke patients' early thrombolytic efficacy.
We collect basic facts and clinical data of stroke patients with intravenous thrombolysis. A nomogram was established for predicting early thrombolytic efficacy in these people. The LASSO regression method and multivariate logistic regression were used to filter variables and choose predictors. Predictors were applied to develop a model. The model's discriminatory capacity was assessed by computing the area under the curve. In addition, the model's calibration analysis and decision curve analysis were performed.
Using multivariate logistic regression and LASSO regression techniques, five variables were chosen. These variables were age, NIHSS score before thrombolysis, prothrombin time, neutrophil count, and monocyte count. The AUC of the prediction model was 0.761 (95% CI, 0.717-0.805) in the training set and 0.744 (95% CI, 0.653-0.835) in the test set. The decision curve showed that the threshold probabilities for the effectiveness of early thrombolysis in cerebral infarction are 25-67% and 25-73% in the training set and test set, respectively.
A novel nomogram with age, NIHSS score before thrombolysis, prothrombin time, neutrophil count, and monocyte count as variables has the potential to predict early thrombolytic efficacy in stroke patients. Physicians could utilize this handy nomogram to make better decisions for stroke patients with intravenous thrombolysis.
本研究的目的是开发并验证一种用于预测中风患者早期溶栓疗效的新型列线图。
我们收集了接受静脉溶栓治疗的中风患者的基本情况和临床数据。建立了一个列线图来预测这些患者的早期溶栓疗效。使用LASSO回归方法和多因素逻辑回归来筛选变量并选择预测因子。将预测因子应用于建立模型。通过计算曲线下面积评估模型的鉴别能力。此外,还进行了模型的校准分析和决策曲线分析。
使用多因素逻辑回归和LASSO回归技术,选择了五个变量。这些变量为年龄、溶栓前美国国立卫生研究院卒中量表(NIHSS)评分、凝血酶原时间、中性粒细胞计数和单核细胞计数。预测模型在训练集中的曲线下面积(AUC)为0.761(95%置信区间,0.717 - 0.805),在测试集中为0.744(95%置信区间,0.653 - 0.835)。决策曲线显示,训练集和测试集中脑梗死早期溶栓有效性的阈值概率分别为25% - 67%和25% - 73%。
一种以年龄、溶栓前NIHSS评分、凝血酶原时间、中性粒细胞计数和单核细胞计数为变量的新型列线图有潜力预测中风患者的早期溶栓疗效。医生可以利用这个便捷的列线图为接受静脉溶栓治疗的中风患者做出更好的决策。