Risk factors and a model for prognosis prediction after intravenous thrombolysis with alteplase in acute ischemic stroke based on propensity score matching.

IF 3.5 3区 医学
Pan Huang, XingYang Yi
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引用次数: 0

Abstract

Background: Alteplase intravenous thrombolysis is effective for treating acute ischemic stroke (AIS) within 4.5 h. Nevertheless, the prognosis remains poor for some patients.Objective: To investigate the risk factors for poor prognosis in patients undergoing intravenous thrombolysis with alteplase following AIS based on propensity score matching and to develop a predictive model.Result: Multivariate logistic regression analysis showed that baseline blood glucose (OR = 1.20, 95%CI, 1.03-1.39), baseline NIH Stroke Scale score (OR = 1.23, 95%CI, 1.12-1.35), and hyperlipidemia (OR = 6.60, 95%CI 1.74-25.00) were risk factors for poor prognosis in patients with AIS undergoing alteplase intravenous thrombolysis. Using these factors, a nomogram model was constructed for predicting patient prognosis at 3 months. The areas under the receiver operating characteristic curve (AUCs) of the training and validation groups were 0.792 (95CI% 0.715-0.870) and 0.885 (95CI% 0.798-0.972), respectively, showing good differentiation. The Hosmer Lemeshow goodness-of-fit test showed that the model had good fit. The calibration curve fitted well with the ideal curve, and the decision curve analysis curve showed that the model had good clinical applicability when the threshold probability was between 10%-80%.Conclusion: The established nomogram could successfully predict the 3-month prognosis of patients with AIS after undergoing alteplase intravenous thrombolysis. The model thus has clinical application value.

基于倾向评分匹配的急性缺血性脑卒中阿替普酶静脉溶栓后的风险因素和预后预测模型。
背景:阿替普酶静脉溶栓可在4.5小时内有效治疗急性缺血性脑卒中(AIS),但部分患者的预后仍较差:基于倾向评分匹配,研究接受阿替普酶静脉溶栓治疗的 AIS 患者预后不良的风险因素,并建立预测模型:多变量逻辑回归分析显示,基线血糖(OR = 1.20,95%CI,1.03-1.39)、基线NIH卒中量表评分(OR = 1.23,95%CI,1.12-1.35)和高脂血症(OR = 6.60,95%CI 1.74-25.00)是接受阿替普酶静脉溶栓治疗的AIS患者预后不良的危险因素。利用这些因素构建了一个预测患者 3 个月预后的提名图模型。训练组和验证组的接收器操作特征曲线下面积(AUC)分别为 0.792(95CI% 0.715-0.870)和 0.885(95CI% 0.798-0.972),显示了良好的区分度。Hosmer Lemeshow 拟合优度检验表明模型拟合良好。校准曲线与理想曲线拟合良好,决策曲线分析曲线显示,当阈值概率在10%-80%之间时,模型具有良好的临床适用性:结论:建立的提名图能成功预测接受阿替普酶静脉溶栓治疗后 AIS 患者 3 个月的预后。因此,该模型具有临床应用价值。
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来源期刊
International Journal of Immunopathology and Pharmacology
International Journal of Immunopathology and Pharmacology Immunology and Microbiology-Immunology
自引率
0.00%
发文量
88
期刊介绍: International Journal of Immunopathology and Pharmacology is an Open Access peer-reviewed journal publishing original papers describing research in the fields of immunology, pathology and pharmacology. The intention is that the journal should reflect both the experimental and clinical aspects of immunology as well as advances in the understanding of the pathology and pharmacology of the immune system.
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