Nomogram for Deep Vein Thrombosis Prediction Post-Endovascular Thrombectomy in Acute Ischemic Stroke: A Retrospective Multicenter Observational Study.

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing Pub Date : 2025-04-18 DOI:10.1111/jocn.17786

Li Han, Teng-Wei Pan, Li-Li Yang, Wei-Yang Qian, Xiao-Ping Xu, Feng Wang, Wei-Zhen Wang, Yang Liu, Wei-Ying Yang

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引用次数: 0

Abstract

Background: Deep vein thrombosis (DVT) is a frequent complication following endovascular thrombectomy (EVT) in patients with acute ischaemic stroke (AIS), potentially leading to fatal pulmonary embolism (PE). Identifying patients early at high risk for DVT is clinically important. This study developed and validated a nomogram combining laboratory findings and clinical characteristics to predict the risk of lower-extremity DVT after EVT in patients with AIS.

Methods: This retrospective multicentre observational study was conducted in two tertiary hospitals in China, enrolling 640 patients who underwent ultrasonography for DVT diagnosis within 10 days following EVT. Data on medical history, examination and laboratory results were collected for logistic regression analyses to develop a DVT risk nomogram.

Results: Logistic regression analyses identified critical predictors of DVT: lower limb National Institutes of Health Stroke Scale (NIHSS) score ≥ 2, elevated D-dimer levels (≥ 1.62 mg/L) and prolonged puncture-to-recanalization time (PRT ≥ 66 min). The nomogram demonstrated good discriminative ability (AUC 0.741-0.822) and clinical utility across internal and external validation cohorts. Additionally, the presence of DVT was significantly associated with reduced functional independence at 90 days post-EVT, highlighting the negative impact of DVT on patient recovery (OR = 3.85; 95% CI: 2.18-6.78; p < 0.001).

Conclusion: The study provides a practical clinical tool for early detection and intervention in patients with AIS at high risk for DVT following EVT. Early identification and intervention may help improve outcomes in patients with AIS undergoing EVT.

Relevance to clinical practice: This nomogram helps in the early detection and proactive management of DVT in AIS patients, which can reduce severe complications and improve patient recovery outcomes.

Patient or public contribution: No patient or public contributions were involved in this study due to its retrospective design, where data were utilised from existing medical records without direct patient interaction.

查看原文本刊更多论文

急性缺血性卒中血管内取栓术后深静脉血栓形成预测的Nomogram：一项回顾性多中心观察研究。

背景：深静脉血栓形成（DVT）是急性缺血性卒中（AIS）患者血管内血栓切除术（EVT）后常见的并发症，可能导致致命的肺栓塞（PE）。早期识别深静脉血栓高危患者在临床上具有重要意义。本研究开发并验证了一种结合实验室结果和临床特征的nomogram方法来预测AIS患者EVT后下肢DVT的风险。方法：本回顾性多中心观察性研究在中国两家三级医院进行，纳入640例EVT后10天内超声诊断DVT的患者。收集病史、检查和实验室结果的数据进行逻辑回归分析，以建立DVT风险图。结果：Logistic回归分析确定了DVT的关键预测因素：下肢美国国立卫生研究院卒中量表（NIHSS）评分≥2，d -二聚体水平升高（≥1.62 mg/L），穿刺至再通时间延长（PRT≥66 min）。在内部和外部验证队列中，nomogram显示出良好的判别能力（AUC 0.741-0.822）和临床实用性。此外，DVT的存在与evt后90天功能独立性降低显著相关，突出了DVT对患者康复的负面影响(OR = 3.85；95% ci: 2.18-6.78；结论：本研究为AIS EVT后DVT高危患者的早期发现和干预提供了实用的临床工具。早期识别和干预可能有助于改善接受EVT的AIS患者的预后。与临床实践的相关性：该图有助于AIS患者DVT的早期发现和主动管理，可以减少严重并发症，提高患者的康复效果。患者或公众贡献：由于采用回顾性设计，本研究没有涉及患者或公众贡献，数据来自现有的医疗记录，没有与患者直接互动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.