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Predictive Model of Early Neurological Deterioration in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Mar; Vol. 30 (3), pp. 105459. Date of Electronic Publication: 2020 Dec 30. - Publication Year :
- 2021
-
Abstract
- Objective: This study aimed to develop a predictive model of early neurological deterioration (END) in patients with acute ischemic stroke (AIS).<br />Methods: The present retrospective cohort study considered patients with AIS who were admitted to a tertiary hospital in Shenzhen, China between January 2014 and December 2018. An increase of 2 points or more on the National Institute of Health Stroke Scale (NIHSS) within 7 days indicated END. We selected baseline clinical, laboratory, and neuroimaging variables to construct predictive models through multivariate logistic regression. The receiver operating characteristic curve and calibration plots were calculated.<br />Results: A total of 391 patients with AIS were enrolled in the study. END was observed in 64 (16.4%) cases. A prediction model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of≥ 50% showed good discriminative ability: area under the receiver operating characteristic curve, 0.870 (95%CI, 0.813-0.911); threshold, -1.570; specificity, 84.40%; sensitivity, 75.00%; positive predictive value, 48.48%; and a negative predictive value, 94.52%.<br />Conclusion: Our predictive model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of ≥ 50% could identify patients with AIS who were at risk of developing END. The model requires validation by larger studies performed at other institutions.<br /> (Copyright © 2020. Published by Elsevier Inc.)
- Subjects :
- Aged
Aged, 80 and over
Carotid Stenosis diagnosis
Carotid Stenosis physiopathology
Disease Progression
Female
Humans
Infarction, Middle Cerebral Artery diagnosis
Infarction, Middle Cerebral Artery physiopathology
Ischemic Stroke etiology
Ischemic Stroke physiopathology
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Carotid Stenosis complications
Clinical Decision Rules
Disability Evaluation
Infarction, Middle Cerebral Artery complications
Ischemic Stroke diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 30
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 33387889
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105459