Skip to main content

ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1487248

Nomogram to predict three-month prognosis of acute ischemic stroke among young adults

Provisionally accepted
Qian He Qian He 1,2Miaoran Wang Miaoran Wang 1*Haoyue Zhu Haoyue Zhu 2*Ying Xiao Ying Xiao 3*Rui Wen Rui Wen 2*Xiaoqing Liu Xiaoqing Liu 1Yangdi Shi Yangdi Shi 1*Linzhi Zhang Linzhi Zhang 1*Bing Xu Bing Xu 2*
  • 1 China Medical University, Shenyang, China
  • 2 Shenyang Tenth People's Hospital, Shenyang, Liaoning Province, China
  • 3 Shenyang First People’s Hospital, Shenyang Brain Institute, Shenyang, Liaoning Province, China

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

    Objective: This study aimed to develop and validate a nomogram for predicting the risk of three months adverse outcomes among young adults with acute ischemic stroke(AIS).Methods: Patients aged between 18 and 50 with acute ischemic stroke (AIS) at the Shenyang First's People Hospital, between January 1st 2017 to May 30 th 2023 were included in this retrospective study. The primary outcome was a three-month unfavorable outcome, evaluated with modified Rankin Scale(mRS>2). Univariate logistic regression was used to select the independent factors of prognosis and multivariate logistic regression to establish a new nomogram model. We used the area under the receiver-operating characteristic curve (ROC) to evaluate the discriminative performance and used the calibration curve with Hosmer-Lemeshow goodness of fit test to assess the calibration performance of the risk prediction model. Decision curve analysis (DCA) was applied to assess the clinical utility of the nomogram.Results: A total of 1015 patients were enrolled .Gender (male vs female; Odds ratio[OR], 0.5562[95% Confidence Interval (CI), 0.3104-1.0478];P=0.053), family history of stroke (OR,3.5698[95%CI 1.5632-8.0329],P<0.001), prior stroke(OR, 2.1509[95%CI 1.2610-3.6577], P<0.001), previous heart disease (OR,3.4047[95%CI, 1.7838-6.6976],P<0.01) toast type(cardio-embolism stroke versus large-artery atherosclerosis(LAA), OR,0.0847[0.0043-0.5284],P<0.01), toast type(stroke of undetermined etiology versus LAA, OR, 0.0847[0.0439-0.5284],P<0.01), mRS at admission (OR, 15.2446 [9.1447-26.3156],P<0.0001), adherence to medication (OR,2.1197[95%CI, 1.1924-3.7464],P<0.001), systolic blood pressure(SBP) (OR, 1.0145[1.0041-1.0250],P<0.001), and lactate dehydrogenase(LDH)(OR, 1.0060[1.0010-1.0111],P<0.01) were related to three months adverse outcomes among young adults with AIS. The nomogram displayed excellent calibration and discrimination. DCA confirmed the clinical applicability of the model.The nomogram comprised of gender, family history of stroke, prior stroke , previous heart disease ,toast type, mRS score at admission, adherence to medication ,SBP and LDH may predict three months adverse outcomes among young adults with AIS.

    Keywords: nomogram, young adults, Acute ischemic stroke, unfavorable outcomes, predictive model

    Received: 24 Sep 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 He, Wang, Zhu, Xiao, Wen, Liu, Shi, Zhang and Xu. 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:
    Miaoran Wang, China Medical University, Shenyang, China
    Haoyue Zhu, Shenyang Tenth People's Hospital, Shenyang, 110044, Liaoning Province, China
    Ying Xiao, Shenyang First People’s Hospital, Shenyang Brain Institute, Shenyang, 110041, Liaoning Province, China
    Rui Wen, Shenyang Tenth People's Hospital, Shenyang, 110044, Liaoning Province, China
    Yangdi Shi, China Medical University, Shenyang, China
    Linzhi Zhang, China Medical University, Shenyang, China
    Bing Xu, Shenyang Tenth People's Hospital, Shenyang, 110044, Liaoning Province, 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.