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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1433010
This article is part of the Research Topic Advances and controversies in ischemic stroke management: from prevention to diagnosis and acute treatment View all 82 articles

Predictors of early neurological deterioration in patients with acute ischemic stroke

Provisionally accepted
Yang Zhou Yang Zhou 1Yufan Luo Yufan Luo 2Huazheng Liang Huazheng Liang 3,4,5*Wei Zhenyu Wei Zhenyu 6Ping Zhong Ping Zhong 6*Danhong Wu Danhong Wu 2*
  • 1 Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
  • 2 Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China
  • 3 Suzhou Industrial Park Monash Research Institute of Science and Technology, suzhou, China
  • 4 Southeast University-Monash University Suzhou Joint Graduate School, Suzhou, Jiangsu Province, China
  • 5 Monash University - Southeast University Joint Research Institute (Suzhou), Suzhou, Jiangsu Province, China
  • 6 Shanghai Shidong Hospital of Yangpu District, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: The present study aimed to develop a reliable and straightforwardNomogram by integrating various parameters to accurately predict the likelihood of early neurological deterioration (END) in patients with acute ischemic stroke (AIS).: AIS patients from Shaoxing People's Hospital, Shanghai Yangpu District Shidong Hospital, and Shanghai Fifth People's Hospital were recruited based on specific inclusion and exclusion criteria. The primary outcome was END. Using the LASSO logistic model, a predictive Nomogram was generated. The performance of the Nomogram was evaluated using the ROC curve, the Hosmer-Lemeshow test, and a calibration plot. Additionally, the decision curve analysis was conducted to assess the effectiveness of the Nomogram. Results: It was found that the Nomogram generated in the present study showed strong discriminatory performance in both the training and the internal validation cohorts when their ROC-AUC values were 0.715 (95% CI 0.648-0.782) and 0.725 (95% CI 0.631-0.820), respectively. Similar results were observed in two external validation cohorts when their ROC-AUC values were 0.685 (95% CI 0.541-0.829) and 0.673 (95% CI 0.545-0.800), respectively. In addition, CAD, SBP, neutrophils, TBil, and LDL were found to be positively correlated with the occurrence of END post-stroke, while lymphocytes and UA were negatively correlated. Conclusion: Our study developed a novel Nomogram that includes CAD, SBP, neutrophils, lymphocytes, TBil, UA, and LDL and it demonstrated strong discriminatory performance in identifying AIS patients who are likely to develop END.

    Keywords: Outcome, Early neurological deterioration, nomogram, Ischemic stroke (IS), Predict

    Received: 15 May 2024; Accepted: 08 Aug 2024.

    Copyright: © 2024 Zhou, Luo, Liang, Zhenyu, Zhong and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Huazheng Liang, Suzhou Industrial Park Monash Research Institute of Science and Technology, suzhou, China
    Ping Zhong, Shanghai Shidong Hospital of Yangpu District, Shanghai, China
    Danhong Wu, Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.