Prediction of early neurological deterioration in acute ischemic stroke patients treated with intravenous thrombolysis

Author:

Tian Tian1,Wang Lanjing23,Xu Jiali23ORCID,Jia Yujie1,Xue Kun1,Huang Shuangfeng23,Shen Tong3,Luo Yumin3,Li Sijie234,Min Lianqiu1

Affiliation:

1. Department of Neurology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China

2. Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China

3. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China

4. Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China

Abstract

A proportion of acute ischemic stroke (AIS) patients suffer from early neurological deterioration (END) within 24 hours following intravenous thrombolysis (IVT), which greatly increases the risk of poor prognosis of these patients. Therefore, we aimed to explore the predictors of early neurological deterioration of ischemic origin (ENDi) in AIS patients after IVT and develop a nomogram prediction model. This study collected 244 AIS patients with post-thrombolysis ENDi as the derivation cohort and 155 patients as the validation cohort. To establish a nomogram prediction model, risk factors were identified by multivariate logistic regression analysis. The results showed that neutrophil to lymphocyte ratio (NLR) (OR 2.616, 95% CI 1.640–4.175, P < 0.001), mean platelet volume (MPV) (OR 3.334, 95% CI 1.351–8.299, P = 0.009), body mass index (BMI) (OR 1.979, 95% CI 1.285–3.048, P = 0.002) and atrial fibrillation (AF) (OR 8.012, 95% CI 1.341–47.873, P = 0.023) were significantly associated with ENDi. The area under the curve of the prediction model constructed from the above four factors was 0.981 (95% CI 0.961–1.000) and the calibration curve was close to the ideal diagonal line. Therefore, this nomogram prediction model exhibited good discrimination and calibration power and might be a reliable and easy-to-use tool to predict post-thrombolysis ENDi in AIS patients.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical),Neurology

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