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To explore the risk factors of early neurological deterioration (END) in patients with acute ischemic stroke(AIS) and establish a predictive model.
In total 622 AIS patients treated in Baiyun Hospital affiliated to Guizhou Medical University from January 2018 to December 2022 were selected and divided into END group (n=127) and non-END group (n=495) according to the diagnostic criteria of outcome events. The clinical baseline data, laboratory data, and imaging data of the patients were retrospectively collected. Based on the Logistic regression algorithm, risk factors for the development of END were investigated. The prediction model was constructed and nomogram was drawn, and the prediction value of the model was evaluated by discrimination, calibration, and clinical applicability.
Multivariate Logistic regression analysis showed that heart rhythm, middle cerebral artery stenosis, carotid artery stenosis, admission NHISS score, fibrinogen, albumin, and brain natriuretic peptide (BNP) were independent risk factors for END. The prediction model was developed using Stata software, and a nomogram was created. Verification set analysis revealed that the predictive model predicted the risk of END with good discrimination, accuracy, and clinical applicability, with an AUC of 0.888 (95%CI: 0.821-0.955), slope of the calibration curve which was close to 1, and net benefit of the clinical decision curve that exceeded the two reference lines.
The model constructed in this study has high degree of discrimination, calibration, and clinical applicability and has good comprehensive prediction efficiency, which has a certain clinical application value for the early prediction of END.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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