Volume 22 Issue 7
Jul.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(7): 1108-1111
WANG Yu, LIU Caidan, ZHOU Yunbo, ZHANG Hui, LUO Huanwen. Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1108-1111. doi: 10.16766/j.cnki.issn.1674-4152.003577
Citation: WANG Yu, LIU Caidan, ZHOU Yunbo, ZHANG Hui, LUO Huanwen. Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1108-1111. doi: 10.16766/j.cnki.issn.1674-4152.003577
shu

Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke

doi: 10.16766/j.cnki.issn.1674-4152.003577

  • Department of Neurology, the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410007, China

Funds:

 202011000475

  • Received Date: 2023-10-17
    Available Online: 2024-09-05
    Abstract
  •   Objective  To establish and validate a nomogram prediction model for vessel re-occlusion after intravenous thrombolysis in acute ischaemic stroke (AIS).  Methods  A total of 316 patients with AIS who received intravenous thrombolysis at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2020 to June 2023 were retrospectively analyzed, and divided into non-occlusion group (264 cases) and re-occlusion group (52 cases) according to the status of re-occlusion after intravenous thrombolysis. The differences in clinical characteristics between the two groups were compared, factors affecting vessel re-occlusion were analyzed by multivariate logistic regression and a nomogram model was created. The degree of discrimination and calibration of the model was assessed by using receiver operating characteristic (ROC) and calibration curves, and the clinical decision curve was analyzed.  Results  Univariate and multivariate logistic regression analysis showed that history of atrial fibrillation, high baseline National Institutes of Health Stroke Scale (NIHSS) score and longer time from onset to treatment were risk factors for re-occlusion after intravenous thrombolysis in AIS patients, whereas Tirofiban was protective factor (P < 0.05). The area under ROC curve (AUC) of the constructed nomogram model was 0.768 (0.701-0.835). The calibration curve showed that there was good agreement between the prediction of vessel reocclusion by the model and the actual probability of occurrence (Hosmer-Lemeshow χ2=8.246, P=0.410). If the risk of vessel re-occlusion after thrombolysis in AIS patients is predicted to be >0.15 using this model, appropriate interventional measures should be taken. It can make patients get better clinical benefit.  Conclusion  There are many factors that influence vessel re-occlusion after intravenous thrombolytic therapy in AIS patients, and the reasonably constructed column diagram model has good discriminatory power and accuracy, which can be used for risk stratification of patients.

     

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